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L19,20,21, Chest , pediatrics

    Lecture Video part1

Croup acute bronchitis 


Lecture Video part2 

بداية B. A


Lecture Video part3

باقي B. A

Lecture Video part4

Pneumonia and pleurisy




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MCQ  


1- Noisy breathing because of inspiratory obstruction is called
a. Wheeze

b. Stridor

c. Crepitation

d. None



2- The peak age at which bronchiolitis is common is

a. 1 month

b. 6 months

c. 9 months

d. 12 months



3. An 18-month-old female presents to the emergency department with marked respiratory distress associated with inspiratory and expiratory wheezing and a barking cough. Her history reveals that she had an upper respiratory infection for 2-3 days when she awoke from sleep with inspiratory stridor.  Which of the following is most helpful in differentiating this as croup rather than bronchiolitis?


A) High grade fevers

B) The child's age of 18 months

C) Improvement in symptoms with an aerosol of racemic epinephrine

D) Biphasic wheezing

E) The history of a preceding URTI




4. A factor in the pathogenesis of bronchial obstruction in bronchial asthma is:

a. Smooth muscle spasm

b. Mucosal wall edema

c. Hyper secretio

d. All of the above




5. The commonly used bronchodilators include all the following, Except:

a. Beta adrenergic agonists

b. Xanthenes derivatives

c. Mast cell stabilizer

d. Anticholinergics.




6. 2 months child fever, and increased work of breathing manifested by tachypnea and retractions. Achest x-ray confirms lobar pneumonia. What is the most likely etiology of pneumonia in this child?

(A) Mycoplasma pneumoniae

(B) Streptococcus pyogenes

(C) Chlamydophila pneumoniae

(D) Streptococcus pneumonia

(E) Staphylococcus epidermidis



7. A 3-month-old infant has had upper respiratory symptoms for a few days and presents to the emergency department with respiratory distress, wheezing, and hypoxia. What is the most common cause?

(A) respiratory syncytial virus

(B) parainfluenza virus

(C) cytomegalovirus

(D) influenza virus

(E) human metapneumovirus


8. Stridor is a characteristic of:

a. Bronchiolitis

b. Laryngitis

c. Asthma

d. Bronchopneumonia

9. Wheezing may be found in a child with:

a. Foreign body inhalation

b. Gastric contents aspiration

c. Viral bronchiolitis

d. All of the above

10. The most common roentgenographic abnormality in a child with asthma is which of the following?

(A) bronchiectasis

(B) generalized hyperinflation

(C) lower lobe infiltrates

(D) pneumomediastinum

(E) right middle lobe atelectasis



11. Deviation of the mediastinum to the right is caused by:

a. Left pleural effusion

b. Cardiomegaly

c. Right lower lobe consolidation

d. None of the above

12.A10-year-old with a history of asthma presents to the emergency department in respiratory distress. You auscultate diffuse wheezing and the patient has increased work of breathing. You initiate albuterol via nebulizer, oral steroids, and establish IV access. The patient is showing signs of worsening work of breathing, which one of the following medications can act as an acute bronchodilator?

(A) magnesium sulfate

(B) calcium chloride.

(C) sodium phosphate

(D) potassium chloride

(E) sodium bicarbonate



13. A10-month-old female presents in winter with 2 days of rhinorrhea, tachypnea, and wheezing. She has respirations of 60 breaths per minute, HR of 160 beats per minute, and an oxygen saturation of 90% on room air. Examination reveals an alert infant in mild respiratory distress with mild intercostals retractions and coarse bilateral expiratory wheezing. Appropriate therapy for this infant should begin with which of the following?

(A) intravenous access and a 20 cc/kg bolus of normal saline

(B) oxygen by nasal canula

(C) bag-valve mask followed by rapidsequence intubation

(D) posterior-anterior and lateral chest radiographs

(E) intravenous corticosteroids




14. Which of the following is the best additional therapeutic option for this patient?

(A) inhaled beta agonist therapy

(B) ribavirin

(C) extracorporeal membrane oxygenation

(D) palivizumab (Synagis)

(E) Heliox


15. In children with bronchospasm which one of the following statements is true?

a) Breathlessness is due to cough)

b) Inspiratory phase of breathing is prolonged)

c) Peak flow is impaired and reversed by bronchodilators)



Answers


1/B

2/B

3/E

4/D

5/C

6/D

7/A

8/B

9/D

10/B

11/A

12/A

13/B

14/A

15/C

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