Answer and Explanation 13

13.  Answer C is the correct answer.  Leukotriene inhibitors have not been shown to be helpful in COPD.  Smoking cessation is the most important component.  The long acting parasympatholtyic Spiriva is helpful as is the beta 2 agnoist albuterol.

Question 13


13.  Which of the following is least effective in COPD?

A.  Smoking Cessation

B.  Spiriva

C.  Singulair

D.  Albuterol

Answer and Explanation 12

12.  D is the correct answer.  An empyema (pleural space abscess) is not likely to cause hemopytsis.  Wegner's Granulamatosis is a vasculitis that can cause pulmonary hemorrhage and needs immunosuppression.  Active TB can cause hemoptysis but is usually accompanied with night sweats.  Pulmonary embolus can cause hemoptysis also.  

Question 12


12. Which of the following is not in the differential diagnosis in a patient with hemoptysis?

A.  Wegner’s Granulamatosis

B.  Tuberculosis

C.  Pulmonary Embolus

D.  Empyema

Answer and Explanation 11

11.  The correct answer is C.  This is a clinical scenario consistent with DKA.  This would be more difficult to interpret if this COPD patient was a chronic COPD retainer. You would have to look for a widened anion gap as well as a serum acetone to make the diagnosis.  Given the circumstances it is really not necessary.

Question 11


11.  Your patient is a 56 year old male who has a history of COPD and IDDM.  He presents with a blood sugar of 456.  He presents with shortness of breath, fever, nausea , and vomiting.  The patient’s ABG is as follows:  pH 7.23. PaCO2-23, HCO3-15.  Which of the following is the most accurate description of the clinical scenario above:

A.  The patient has a respiratory acidosis

B.  The patient has a a metabolic alkalosis

C.  The patient has a metabolic acidosis

D.  The patient has a respiratory alkalosis