Answer and Explanation 19

19.  B is the correct answer.  this patient needs admitted to the hospital.  Patients that are under 2 months of age that are RSV positive require hospitalization.  There airways are too small and they will tend to get worse at night.  Synagis is actually an RSV vaccine and would not be helpful at this point.  Giving the patient an albuterol aerosol may help but the patient still needs to be admitted.

Question 19

19.   Your patient is a 6 week old brought into the hospital because of cough and nasal congestion.  Your patient’s lungs are clear, there are no retractions, or signs of respiratory distress.  Vital signs are Temp-97.5 Rectal, Sat-99%, RR-28, Pulse 136.  The child looks well and has been feeding well. He is full term.  The triage nurse has ordered a Chest X Ray that shows “mild bronchiolitis” and an RSV that came back positive.  Based upon this data, which is the best management option?

A.   Discharge the patient home.

B.  Admit the patient to the hospital

C.  Order an albuterol aerosol and reassess the patient

D. Order Synagis IM Stat

Answer and Explanation 18

18.  B is the correct answer.  Small cell carcinoma is the most aggressive form of lung cancer.   Adenocarcinoma and Mesothelioma are less aggresive.  Pancoast tumor is a malignant tumor that usually involves the apex of the lung.

Question 18

18.   Which of the following lung cancer tends to be the most aggressive form of lung cancer?

A.   Adenocarinoma of the Lung

B.  Small Cell Carcinoma

C.  Mesothelioma

D.  Pancoast Tumor

Answer and Explanation 17

17.  A is the correct answer.  The patient has a lung mass.  Avelox would be correct if the patient had community acquired pneumonia.  A PPD would be appropirate if the patient had a cavitary lesion suspicious for TB.  They are mostly located in the upper lobes because of the aerobic nature of mycobacterium.  Rifampin would be appropriate for a patient with tuberculosis.

Question 17

17.  Your patient is a 63 year old male who presents with a chest x ray on this page.

 Based upon your x ray interpretation, what is the next best management option?

A.   Order a CT scan of the Chest with IV contrast

B.  Start the patient on Avelox 400 mg IV

C.  Start the patient on Rifampin

D.  Order a PPD on the patient