PEBC - Therapeutic (Musculoskeletal, Asthma, COPD, Respiratory Tract Infections) Sample Questions Set-5

Categories: PEBC Canada

Ques. AW is a 68-yo male who presented to the ED this morning at 0200 hours with a 2 day history of productive cough with fever. He also complained of shortness of breath. He decided to seek medical treatment because the chest pain and other symptoms were preventing restful sleep. It was decided to admit AW to the hospital with a diagnosis of community-acquired pneumonia. The following antibiotic regimen was ordered: Ceftriaxone 1 g IV q 12 h and clarithromycin 500 mg po q 12 h. What comment would you make during rounds this morning regarding the dosing of the antibiotics?

I) The ceftriaxone and clarithromycin doses must be reduced based on Albert’s estimated renal function.

II) These antibiotics should be given at least 1 hour apart.

III) Ceftriaxone can be given q 24 h for the treatment of community acquired pneumonia.

A) I only

B) III only

C) I and II only

D) II and III only

E) I, II, III

 

Answer: (b)

 

Ques. JS is a 78-yo male who was admitted to the hospital yesterday from an area nursing home with fever, chills, vomiting, and severe flank pain. Which of the following would NOT need to be adjusted in a patient with decreased renal function?

a) Ampicillin

b) Ceftazimide

c) Ceftriaxone iv

d) Ticarcillin and clavulanate potassium

e) Piperacillin and tazobactam

 

Answer: (c)

 

Ques. A 6-year-old child experiencing symptoms of stridor, later it was identified as croup. The symptom of croup generally resolves in?

A) 1 week

B) 1 month

C) 5 days

D) 2 days

E) 100 days

 

Answer: (d)

 

Ques. What is recommended therapy for croup?

A) dexamethasone oral

B) dexamethasone inhaler

C) epinephrine inhaler

D) epinephrine im

E) nebulized epinephrine

 

Answer: (a)

 

Ques. A 77 year old female presents to the emergency department with dyspnea, fever to 103, hypotension and mental status changes. Initial evaluation demonstrates a left lower lobe infiltrates. Additional studies show blood pressure of 90/60, respiratory rate of 34, and pulse of 110. Laboratory parameters include WBC of 2.3, and BUN of 33, with creatinine of 1.3. Pulse oximetry reveals 88% on room air, which comes up to 99% on 4 liters. Based upon the above presentation, which of the following is the most appropriate course of action?

A. Discharge the patient on oral azithromycin

B. Admit the patient to the general medical ward and begin intravenous doxycycline and azithromycin

C. Admit the patient to the intensive care unit, and begin fluid resuscitation, and intravenous ampicillin-sulbactam and levofloxacin.

D. Admit the patient to the intensive care unit and initiate mechanical ventilation, pressors, and intravenous piperacillin-tazobactam

 

Answer: (c)

 

Ques. A 60-year-old patient with COPD. His doctor prescribed him tiotropium (Spiriva), but he still has some signs and symptoms of COPD during the day although he complains of using his medication. Best therapy as an add on is/are:

I. Add ipratropium to Spiriva for 8 to 10 days

II. Add salbutamol to Spiriva

III. Add inhaled corticosteroid to Spiriva

 

A) I only

B) III only

C) I and II

D) II and III

E) I, II, III

 

Answer: (c)

Ques. His doctor wants to do an assessment for his COPD to assess his condition during an exacerbation. Best monitoring parameters to assess his condition is:

(A) Respirometer and histamine test challenge

(B) Peak flow meter

(C) Arterial blood gas determination

(D) X-ray to the chest

(E) None of the above

 

Answer: (c)

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