A chronic cough lasts longer than: - ANS-3 weeks You are doing a cerumen extraction and touch the external meatus of your pt's ear. He winces and starts coughing. What is the name of this reflex? - ANS-Arnold reflex Julie has a postnasal drip along with her cough. You assess her for: - ANS-Allergic or vasomotor rhinitis A pt with HTN comes in and insists that one of his new meds is causing him to cough. When looking at his list of meds, you think the cough must be from: a. Metoprolol b. Clopidogrel c. Tadalafil d. Captopril - ANS-d. Captopril African American pt's seems to have a negative reaction to which of the following asthma meds? a. Inhaled corticosteroids b. Long-term beta-agonist bronchodilators c. Leukotriene receptor agonists d. Oral corticosteroids - ANS-b. Long-term beta-agonist bronchodilators Sam, age 78, presents to the clinic w/respiratory symptoms. His PFTs are as follows: normal total lung capacity, decreased PaO2, increased PaCO2. On assessment, you auscultate course crackles and forced expiratory wheezes. What is your dx? - ANSChronic bronchitis You are using the CURB-65 clinical prediction tool to decide whether Mabel, whom you have diagnosed with community-acquired pneumonia (CAP), should be hospitalized or treated at home. Her score is 3. What should you do? - ANSHospitalize and consider admitting her to the ICU Why do you suspect that your pt may have a decreased response to the TB test? a. She is on a high-protein diet b. She is an adolescent c. She has been on long-term corticosteroid therapy d. She just got over a cold - ANS-c. She has been on long-term corticosteroid therapy Marci has been started on a TB regimen. Because isoniazid (INH) may cause peripheral neuropathy, you consider ordering which of the following drugs prophilactically? a. Pyroxidine b. Thiamine c. Probiotic d. Phytonadione - ANS-a. Pyroxidine Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean? - ANS-The cancer is less than 2cm in size and has not spread to the lymph nodes or other parts of the body Nathan, a 32yo policeman, has a 15-pack-year history of smoking and continues to smoke heavily. During every visit, he gets irate when you try to talk to him about quitting. What should you do? - ANS-Continue to ask him at every visit if he is ready to quit Your pt has decided to try to quit smoking with Chantix. You are discussing his quit date and he will begin taking the med tomorrow. When should he plan to quit smoking? - ANS-His quit date should be in 1 week Which info should be included when you are teaching your pt about the use of nicotine gum? a. The gum must be correctly chewed to a softened state and then placed in the buccal mucosa. b. Pt's should not eat for 30min prior to or during the use of the gum. c. Initially, one piece is chewed every 30min while awake. d. Acidic foods and beverages should be encouraged during nicotine therapy. - ANSa. The gum must be correctly chewed to a softened state and then placed in the buccal mucosa. Your pt states he has a strep throat infection. Which of the following symptoms makes you consider a viral etiology instead? a. Fever b. HA c. Exudative pharyngitis d. Rhinorrhea - ANS-d. Rhinorrhea What is the first-line recommended treatment against Group A beta-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis? - ANS-PCN Cydney presents with a h/o asthma. She has not been treated for a while. She c/o daily but not continual symptoms, greater than 1 week and at nighttime. She has been using her rescue inhaler. Her FEV1 is 60-80% predicted. How would you classify her asthma severity? - ANS-Moderate persistent Joyce is taking a long-acting beta agonist for her asthma. What additional med should she be taking? - ANS-Inhaled corticosteroid