Answer 45

45.  Choice D is the correct answer.  The indications for synagis are:  preterm birth less than 35 weeks, congenital heart disease, and children less than 24 months with bronchopulmonary dysplasia.

Question 45

45.  All of the following are indications for the synagis vaccine except:

A.  Preterm birth less than 35 weeks
B.  Significant congenital heart disease
C.  Children less than 24 months with bronchopulmonary dysplasia
D.  Patients who are exposed to significant second hand smoke

Answer 44

44.  Choice A is the correct answer.  Mycoplasma is considered an atypical organisms but is common in patients who use tobacco.  CMV and Cryptococcus are seen in patients that are immunosuppressed or organ transplant patients.  Pseudomonas is usually seen in patients with structural lung disease or those who have been on corticosteroids. 

Question 44

44.  Your patient is a 54 year old healthy male that presents with a productive cough and fever.  He does smoke cigarettes.  He has a right sided pneumonia.  Which of the following is a likely organism for that would grown in this patients sputum culture?

A.  Mycoplasma Pneumonia
B.  Cytomegalovirus
C.  Cryptococcus
D.  Pseudomonas

Answer 43

43.  Choice B is the correct answer.   The parainfluenza virus is the most common organism causing croup.  Influenza and adenovirus typically afflict the upper airways.  RSV typically afflicts the lower airways in children.

Question 43

43.  Your patient is a 4 year old male that presents with a bark cough and a steeple sign seen on his soft tissue neck x-ray.  Which organism is he likely afflicted with?

A.  Influenza

B.  Parainfluenza 

C.  Adenovirus

D.  RSV

Answer 42

42.  Choice A is the correct answer.  Bordetella pertussis is the organism that causes pertussis or whooping cough.  Children are usually immunized against this but occasionally will see in older adults or children that are not immunized.  Legionella is an atypical organism that is related to aquatic environments.  Acid fast bacillus is consistent with mycobacterium tuberculosis that causes TB.

Question 42

42.  Your patient is a 8 year old female that presents with uncontrollable coughing for several weeks.  She is "one set behind" on her immunizations.  Which of the following organisms is she likely afflicted with?

A.  Acid Fast Bacillus
B.  Bordetella
C.  Legionella
D.  Streptococcus Pneumonia

Answer 41

41.  Choice B is the correct answer.  This patient has a creatinine over 2.0 so injecting with IV contrast is contraindicated.  Pulmonary Angiography could make the diagnosis but is invasive and a V/Q scan could be used to make the diagnosis.  Thrombolytics should only be used if the patient is hemodynamically unstable and hypotensive.

Question 41

41.  Your patient is a 45 year old female who smokes cigarettes and is on birth control pills complaining of right sided chest pain and shortness of breath.  Her vital signs are as follows heart rate was 128, respiratory rate 28, temperature 99.1 F, blood pressure was 117/86.  Her BUN was 44 and creatinine was 2.3.  Which of the following is the best management plan?

A.  Order a CTA of the Chest for PE
B.  Order V/Q scan for PE
C.  Order Pulmonary Angiography
D.  Order TPA