ccc exam 3 practice test i went through as many of the old exams

CCC Exam 3 Practice Test

I went through as many of the old exams as I could find. I will take this time to remind everyone that if they do not find my practice exam sufficient, all of us have access to all the old exams and the freedom to look through them on their own. The username/password for the test bank are both VCOM. Enjoy.

15. Which is the most common type of gene mutation found in cystic fibrosis?

A. class IIB. all have the same frequencyC. class ID. class IVE. class III

16. Pancreatic insufficiency in CF is related to which of the following?

A. decreased bowel motilityB. meconium ileusC. sticky lung secretionsD. the delta F508 geneE. decreased serum chloride

17. Which of the following is a finding in CF?

A. chronic rashesB. hearing deficitsC. rectal prolapseD. chronic runny noseE. developmental delay

18. In the treatment of CF, which of the following types of OMM are most useful? (Note: this question came up on two separate exams, each with a different keyed answer. I keyed both here).

A. HVLA of the thoraxB. lumbar rollC. OA decompressionD. Texas twistE. rib raising

39. The characteristics of the mycobacterium unique include

A. aerobic growthB. non spore formersC. acid-fast characteristicsD. beaded rod shape morphologyE. slow growing characteristics

40. TB is;

A. air borneB. water borneC. tick borneD. mosquito borne

E. enterically transferred

41. AIDS patients are at higher risk of developing TB because;

A. of their living environmentB. because they often also suffer from Kaposi’s SarcomaC. their CD-4 helper T cell count is often lowD. they often suffer from pneumocyctis pneumoniaE. they have poor airway cilia activity

42. Tuberculous Meningitis most commonly effects the;

A. sixth cranial nerveB. seventh cranial nerveC. temporal lobeD. eighth cranial nerveE. Brain Stem

1. Which statement regarding Multidrug Resistant TB (MDRTB) is true?A. The MDRTB started in Africa and is not seen developed countries such as the U.SB. MDRTB is the direct result of DOT being used in the distribution of drugsC. MDRTB is the result of single drug treatment that was not completedD. MDRTB is limited to immune-compromised patientsE. All the above are true

2. Which of the following regarding the diagnosis of TB is true?A. Use of the Gram stains is the best way to diagnose tuberculosisB. A culture for TB is less sensitive and less specific than the GM stainC. A chest xray revealing infiltrates localized in the upper lobes indicates first phase

disease D. Use of Acid Fast stains are the best way to diagnose tuberculosisE. A PPD cannot be used on a patient with AIDS for diagnosis

3. The virulence factor in Mycobacterium Tuberculosis is directly related to the:A. The acid fast tubercles on the cell wall B. The “Cord Factor” or long chain fats that bind the cellsC. Quick formation of granulomas that protect the bacilliD. Caseation of the bacilliE. None of the above

4. Which best describes the Chest xray of a patient with TB:A. The Caseation causes necrotic lesions that are visible on the cxray as cavitiesB. The lymph nodes are most often seen at the hilar regionC. Secondary phase infiltrates are in the apical lung region where oxygen tension is

highD. The hallmark lesion is the Ghon Complex on chest xrayE. All the above are characteristic of TB on xray

5. Which of the following describes a common appropriate treatment regimen for TB: thrown out

A. Rifampin, Isonazid, Pyrazinamide and Ethambutol for 3 to 4 mos. Followed by Rifampin and Isonazid for 6 months for pulmonary TB

B. Rifampin, Isonazid, Pyrazinamide and Ethambutol for 2 to 4 mos. Followed by Rifampin and Isonazid for 6 months for bone and joint TB

C. Rifampin, Isonazid, Pyrazinamide, and Ethambutol for 2 mos. Followed by Rifampin or Isonazid for 6 months for an AIDS patient with M. Avium

D. All the above are appropriate treatment regimens for TB

6. What is the best description of Pott’s Disease:A. Mycobacterium TB in the meningesB. Mycobacterium TB causing osteomyelitis of the spineC. Mycobacterium TB causing adrenal infiltrationD. Widespread infection with Mycobacterium TB in the lung and liverE. All the above are characteristic of Pott’s Disease

7. Which best describes the adverse effects of Rifampin and Isonazid: thrown outA. Niacin deficiencies are most often association with dementiaB. Niacin deficiencies are most often cutaneous and nauseaC. B6 deficiencies are most often cutaneous and nauseaD. All the above are true

1. An AIDS patient is admitted with fluffy white infiltrates in the apex of the lungs. The cultures are negative for Mycobacterium Tuberculosis. The patient most likely has:

A. Pseudomonas Aeur.B. KlebsiellaC. BlastomycesD. Mycobacterium Avium

2. The treatment of choice for the patient in 7 is:A. Clartithromycin, azithromycin, and ethambutolB. Clarithromycin, Amphteracin B, and CiprofloxinC. Clarithromycin, Piperacillin, and Cirpofloxin

3. The key feature associated with Mycobacterium TB on xray is:A. Bilaterial lower lobe infiltratesB. Ghon ComplexC. Multiple granulomas throughout the lungD. Abscessed and cavitated lymph nodes

4. All of the following are key to the identification of Mycobacterium Tuberculosis except:A. An Acid Fast StainB. A Gm. Stain

C. A sputum culture D. A Chest x-rayE. PPD

5. The treatment regimens below are all recommended for Mycobacterium TB except:A. 2 to 3 months of Rifampin, Isonazid, Ethambutol, and Pyrazinamide followed by 6

mos. Of Rifampin and Isonazid for lung involvmentB. D.O.T. of Rifampin and Pyrazinamide, Isonazid following the first 4 mos. of RIPE

acute treatmentC. Rifampin, Streptomycin, Isonazid, and Pyrazinamide for 2 to 4 mos followed by

Rifampin and Isonazid for 10 mos. for lung and bone involvementD. Rifampin, Streptomycin, Isonazid, and Pyrazinamide for 2 to 4 mos. Followed

by Rifampin and Isonazid until the PPD converts to negative

6. Which is true of Mutlidrug resistant TB:A. The most common caused is Mycobacterium AviumB. The most common cause is Resistance to Ethambutol and StreptomycinC. The most common cause is believed to be incomplete Rifampin monotherapyD. The most common cause is antigenic shift of the Mycobacteria from the TB vaccine

7. Which of the following is NOT a feature of Mycoplasma Pneumonia:A. Diagnostic tests include an Elisa test (IgM)B. Diagnostic tests include Cold AggluttinsC. Diagnostic tests include Complement Fixation

Diagnostic tests include Acid Fast stains

. A 65 year-old woman presents to your office with a 5-day history of progressive fever that is currently 102.5ºF, trouble breathing, body aches and muscle stiffness, bluish-white fingernails, and a productive cough that is rust colored (blood-tinged). Following an extensive work-up your diagnosis is lobar pneumonia. Which of the following etiologic agents listed below is the MOST LIKELY cause of this pneumonia?

A. LegionellaB. MycoplasmaC. ChlamydophilaD. Streptococcus

12. An 11-year-old boy is brought to your office with a 3-day history of low-grade fever (100.2ºF), chills, muscle aches, cough, and shortness of breath, and based on this information your tentative diagnosis is atypical pneumonia. Upon physical examination you notice a

maculopapular rash on his back, which, along with the above information, leads you to which diagnosis below?

A. Legionella pneumoniaB. Mycoplasma pneumoniaC. Chlamydophila pneumoniaD. Streptococcal pneumonia

25. Choose the correct statement regarding sweat testing:

A. this test cannot be done in infants under age 1 yearB. the test requires a specific amount of sweat for accuracyC. one test is adequate for the diagnosisD. a sweat chloride of less than 60 is diagnostic for CFE. this test can be performed at any lab

8. Which of the following is true regarding Mycoplasma Pneumonia:A. Infects mostly those <5 and >24 yrs of ageB. Requires Elia, Cold Aggluttins, and Complement Fixation tests to diagnose C. Has classic Rapid onset, usually less than 5 days with high fever (> 103)

Causes lobar rather than insterstitial pneumonia on xray

The following questions were included due to the various lectures that included DDx. If they seem too specific for you, don’t look at them.

. A patient who has presented with a complaint of chest pain and dyspnea suddenly becomes agitated. He is now dusky in appearance and is noted to have a drop in blood pressure and a worsening tachycardia. We must consider that he

A. has developed pneumonia.B. has an underlying pneumonia.C. has developed a tension pneumothorax.D. has developed a pneumopericardium.

31. A 54 year old woman, lifelong heavy smoker, presents with cough, excessive sputum production, low blood oxygen level and lower extremity edema of 3 years duration. Which of the following findings characterize her disease?

A. A low hemoglobin level

B. A rapid respiratory rate.

C. Pink nailbeds.

D. Complicating cor pulmonale (right heart failure).

32. Which of the following is NOT a cause of airway narrowing and obstruction in obstructive lung disease?

A. Increased elastic recoil.

B. Bronchial wall thickening.

C. Mucous plugging.

D. Bronchospasm.

33. A 72 year old man presents to you with complaints of progressive shortness of breath, unassociated with wheezing or cough. He has smoked 3 packs of cigarettes daily for 45 years. His CXR shows hyperlucent lung fields. On his physical exam you find hyperexpanded, very quiet lungs. Which of the following best characterize his disease?

A. Complicating cor pulmonale (right heart failure).

B. Progressive edema

C. Cyanotic nailbeds

D. A lung biopsy would show loss of alveolar septae.

34. A 22 year old woman presents to the emergency room with severe shortness of breath, cough and wheezing. She denies smoking but states she had asthma as a child. Based on your presumptive diagnosis, you would expect the following:

A. She feels her chest is “too full” and she has trouble with inspiration.

B. She has a disorder characterized by chest wall stiffness.

C. A lung biopsy would show bronchial wall swelling.

D. A lung biopsy would show thickening of alveolar septae.

1. A 51 year old male presents with a chief complaint of sudden onset of chest pain. He states he was golfing and the pain lasted about 5 minutes and resolved prior to arrival. The pain occurred in the middle of his chest and was pressure like. There was no radiation or other symptoms. Walking on the golf course made the pain worse and he denies any risk factors.

Physical exam: Vitals stable. Lungs: clear, Heart: unremarkable; Abdomen, extremities, skin and musculoskeletal findings all within normal limits.

The most likely diagnosis is:

a. Myocardial Infarctionb. Anginac. Upper GId. Pericarditise. Pulmonary Embolus

2. A 27 year old female presents with the gradual onset of stabbing chest discomfort. It started when she was shopping and has continued for the past two hours. The pain is lateral to the costochondral junction without radiation. She had prodromal flu-like symptoms 3 days ago, gradual difficulty

breathing and a fever. She is coughing up green stuff she states. Nothing worsens the pain and she has no risk factors. Physical exam: Vitals: Temp: 101’F, Resp: 29, Pulse 117. Lungs: coarse wheezing, crackles, rhonchi, unilateral decrease breath sounds. Heart: tachycardic. Abdomen and extremities are unremarkable. Skin: diaphoresis noted.


a. Musculoskeletalb. Pericarditisc. Pulmonary Embolusd. Pneumoniae. Upper GI

3. A 57 year old female presents with the sudden onset of chest discomfort. The pain started when she was working in her garden and has continued for the past two hours. The pain is dull, radiates down her left arm and is located on the left side of her chest. Nothing makes the pain worse. She says she smokes, but would like to quit. She also notes gradual difficulty breathing.

Physical exam: Afebrile, BP 150/94, Pulse 120, Lungs: clear, Heart: tachycardic, S4 gallop. Abdomen and musculoskeletal findings are all unremarkable. Skin: diaphoretic and moist extremities.


a. Myocardial Infarctionb. Pneumoniac. Musculoskeletald. Pneumothoraxe. Thoracic Aneurysm

4. A 49 year old male presents with dyspnea for about 5 hours. He also has brief stabbing chest pain with certain movements. His trouble breathing occurs with exertion and worsens while lying down. He says he is having difficulty smoking since his recent water skiing accident on Claytor Lake. Vital signs: Afebrile, BP: 150/94, Pulse 90, Resp Rate: 26.

Physical exam: HEENT: unremarkable, Heart: no murmur, WNL; Lungs: decreased breath sounds and hyperresonance. Extremities: no edema. Labs: Hb 13/ Hct 41.


a. Pulmonary Embolusb. Asthmac. Pneumothoraxd. Congestive Heart Failuree. COPD

5. A 69 year old male presents with dyspnea for several months that occurs with exertion. Chest pain is not associated with the episode. Other associated findings: coughing, orthopnea, headache and skin lesions. He says he has had similar episodes of trouble breathing without a definite diagnosis. He also smokes. Vital signs: Afebrile, BP: 130/75, Pulse: 110, Resp Rate 32

Physical exam: neck is supple, Heart: grade 2 systolic murmur. Lungs: wheezes, crackles, and decreased breath sounds bilateral, Ext: no edema. Labs: H/H is 12/39.


a. Anemiab. Interstitial Lung Diseasec. Pneumoniad. Pleural Effusione. Myocardial Infarction

6. A 47 year old female comes to the ER with dyspnea for the last 9 hours. She has brief sharp chest pain with certain movements and shortness of breath with exertion. She has also a dry cough. Several days ago she had pelvic surgery. She does not smoke or drink.

Vital signs: Afebrile, BP: 142/84, Resp Rate: 28, Pulse 116... Physical exam: neck is supple, Lungs: wheezes, Heart: tachycardia. Extremities: no edema, but + left calf pain. H/H 11/37.


a. COPDb. Pneumoniac. Pleural Effusiond. Congestive Heart Failuree. Pulmonary Embolus

7. A 53 year old female presents with a productive cough for several days. She denies other associated findings. Prior episodes of cough have been associated with nothing. She has no allergies and is not exposed to air-borne environmental irritants at work. She states nothing reduces the frequency of her cough, except for codiclear. Although her cough is worse when she is supine, she really wants a prescription for codiclear. She does smoke 2 packs a day and has 2 mixed drinks daily. Family history: unremarkable. Vitals: Afebrile, BP, pulse and respirations are all normal. Physical exam: Lungs: crackles in the bases, Heart: without murmur, extremities and neuro exam all normal.


a. Pneumonia

b. Pulmonary Neoplasm

c. Post nasal drip

d. Chronic bronchitis

e. Asthma

8. A 73 year old male comes to your office with a productive cough for 3 days. He says he has recurrent bouts of “chest colds” and is concerned about his copious, purulent sputum. This has left him fatigued and emaciated. Prior episodes of cough have been associated with nothing. Although the supine position increases his cough, the beta agonists reduce his cough. He does not smoke or drink. He denies allergies; is not exposed to air-borne environmental irritants.

No recent immobilizations and no prior surgeries. Vital signs: Afebrile, BP: 134/80, Pulse 72, Resp Rate: 16. Physical Exam: neck: supple, Lungs: crackles in the bases, Heart: without murmur, extremities and neuro exam all normal.


a. Bronchiectasisb. Upper Respiratory Infectionc. Pulmonary Embolusd. Pneumoniae. COPD

11. A 51 year old black male presents for evaluation of his elevated BP, averaging 170/95. He also notes morning headaches, polyuria and polydypsia. Other medical problems include: coronary artery disease, sexual dysfunction and central obesity. Current medications: none. Vitals: BP 188/106. Physical exam reveals a 51 year old male in no acute distress.

HEENT: normal. Heart: normal. Abdomen: benign. Extremities and skin are both normal. Labs: normal BUN and creatinine, elevated Triglycerides, decreased HDL. Special chemistries and urine analysis are both normal. EKG: left ventricular hypertrophy. CXR: normal.


a. Essential Drug Related Hypertensionb. Sleep apneac. Aortic Coarctationd. Chronic Renal Diseasee. Essential Hypertension

12. A 27 year old male comes to the ER on a Saturday night with palpitations and an elevated BP of 168/100. He has had a recent cold, so he is taking over the counter cold meds (OTC). Tonight he has been partying with his buddies and admits to the occasional use of speed.

Vitals: BP: 178/108. Physical exam: HEENT: normal. Heart: is tachycardic at 115 BPM.

Lungs: clear, Extremities and skin: are both normal.

Labs: chemistries and special chemistries are both normal. Urine drug screen is positive for amphetamines. EKG: sinus tachycardia.


a. Essential Drug Related Hypertensionb. Pheochromocytomac. Essential Hypertension

d. Renovascular Diseasee. Sleep Apnea

13. A 57 year old male presents to the ER with heart failure. The third year medical student obtains further history of pressing chest pain, orthopnea and exertional dyspnea.

Vital signs: Afebrile, resp rate 24. Pulse: 124 and regular. BP: 209/95.

Physical exam reveals a 57 year old male in mild distress, diaphoretic. Neck veins distended and a carotid bruit. Heart: lateral PMI, S4 and a grade 2 systolic murmur. Lungs: crackles.

Peripheral edema and normal reflexes.

Workup in the ER shows: CXR: normal. EKG: Acute ST elevations in the anterior leads.

Echocardiogram: poor systolic function.


a. Hyperthyroidismb. Mitral Regurgitationc. Myocarditisd. Myocardial infarction/ischemiae. Aortic Regurgitation

15. A 47 year old female seen in the ER has been diagnosed with heart failure, with no other associated findings. Vital signs: Afebrile, resp rate 22, pulse 123 and irregular, BP: 76/53. Appearance: unremarkable, HEENT: distended neck veins, Heart: lateral PMI, Lungs: crackles, extremities: peripheral edema, Neuro: normal reflexes. Workup reveals: CXR: cardiomegaly, EKG: T wave inversions. Echocardiogram: normal systolic function.


a. Myocarditisb. Congestive Cardiomyopathyc. Arrhythmiad. Aortic Regurgitatione. Restrictive Cardiomyopathy

16. A 5 month old infant presents with difficulty breathing. The dyspnea is associated with a sudden onset of mild cough which is worse at night. The cough is not barking.

Physical exam reveals non toxic 5 month old, vitals: Afebrile, Resp Rate is normal.

Pulse ox is 98%. HEENT: unremarkable, Respiratory exam: stridor, Labs: unremarkable,

CXR: hyperinflation, and slight atelectic streaks, Soft Tissue neck x-ray is negative.


a. Croupb. Foreign Bodyc. Epiglottitisd. Asthmae. Viral Pneumonia

17. A 9 month old infant presents to the ER on your shift with difficulty breathing. Mom says the cough started gradually and is not worsened with activity or time of day. Vitals: temp: 103.4

Resp rate is tachypnec, Pulse ox 97%, HEENT: unremarkable, Lungs: crackles

Labs: WBC> 21,000. CXR: infiltrate, Soft tissue neck: normal.


a. Bacterial Pneumoniab. Asthmac. Croupd. Foreign Bodye. Epiglottitis

18. A 3 year old female is seen in the ER with difficulty breathing. The grandmother says the cough started slowly and is worse with activity. She says the child’s mom smokes in the house and she can not get her to quit. She hopes you will tell her to quit. Vital signs: Afebrile, resp rate reveals tachypnea, Pulse ox: 88%. HEENT: unremarkable,

Respiratory exam: intercostals retractions and wheezing. Labs: WNL.

CXR: hyperinflation and mild atelectic streaks. Soft tissue neck xray: normal.


a. Viral pneumoniab. Asthmac. Bacterial pneumoniad. Croupe. Bronchiolitis

19. A 2 year old male presents with difficulty breathing. Dad says the trouble breathing started suddenly. He says his son has a barky cough which is worse with activity. Physical exam reveals a toxic 2 year old, temperature 103.6’, mildly elevated resp rate, pulse ox 91%,

HEENT: the head is tilted forward, Resp exam: stridor. WBC: 23,500.

Radiology: CXR: normal, Soft tissue neck: reveals a positive “Thumb-sign”.


a. Bacterial pneumonia b. Foreign body c. Croup d. Epiglottitise. Asthma

20. A 7 month old female is seen in the ER with difficulty breathing. Mom says her baby has a mild cough that started gradually, but is not worsened with activity or time of day.

Vital signs: Temp: 101.8. Respiratory rate reveals tachypnea. Pulse ox is 91%.

HEENT: rhinitis. Respiratory exam: intercostals retractions and wheezes.

Labs: nasal swab RSV positive. CXR: hyperinflation. Neck xray: negative.


a. Bronchiolitisb. Croupc. Epiglottitisd. Foreign Bodye. Asthma

21. An 18 month old male comes to your office with difficulty breathing. Grandma says he has his cough is worse at night. His cough started gradually. He has no vomiting and has been healthy in the past. Vitals: Temp. 101.6. Respiratory rate reveals tachypnea. Pulse ox is 92%.

HEENT: rhinitis. Lungs: intercostals retractions, wheezes and crackles.

Labs: unremarkable. RSV swab negative. CXR: shows infiltrate. Neck xray is negative.


a. Foreign Bodyb. Epiglottitisc. Viral Pneumoniad. Croupe. Bronchiolitis

22. A 62 year old male presents for evaluation of a heart murmur. He notes chest pain with moderate exertion and trouble breathing relieved with rest. He also notes fatigue when carrying groceries and palpitations at rest.

Physical exam: HEENT is unremarkable. Lungs: clear. Heart: S4, systolic murmur at the 2nd left sternal intercostal space. PMI is laterally displaced. Arterial evaluation: a weak carotid pulse. Abdomen: normal. Extremities: no edema

Work up reveals: EKG: suggests LVH. CXR: normal cardiac shadow, clear lungs.


a. Atrial septal defectb. Mitral valve prolapsec. Tricuspid Regurgitationd. Mitral Regurgitatione. Aortic Stenosis

23. A 47 year old female presents to your office for evaluation of her heart murmur. She says she has palpitations at rest and a family history of fatigue and also palpitations.

Physical exam: HEENT is normal. Lungs: clear. Heart: systolic click at the apex, a holosystolic murmur after the click. When the patient is supine the click and murmur move later in systole.

PMI at the normal position. Abdomen: normal. Extremities: no edema.

Work up in your office: EKG: Normal. CXR: normal cardiac shadow, clear lungs.


a. Aortic Stenosisb. Mitral Valve Prolapsec. Atrial Septal Defectd. Tricuspid Regurgitatione. Mitral Stenosis

24. A 59 year old male comes to your family practice office for evaluation of his heart murmur. He has trouble breathing with strenuous exertion, but it is relieved with rest. His wife accompanies him and is concerned that he will not be able to mow the lawn this summer.

Physical exam: HEENT: unremarkable. Lungs: fine basilar crackles. Heart: a soft S2, S3 and a diastolic murmur along the left sternal border. A hyperdynamic apical pulse.

Arterial evaluation: a bounding carotid pulse and a to and fro femoral pulse.

Abdomen: normal. Extremities: no edema.

Work up reveals: EKG with Atrial fibrillation. CXR: normal cardiac shadow, clear lungs.


a. Atrial Septal Defectb. Mitral Stenosisc. Aortic Regurgitationd. Mitral Valve Prolapsee. Aortic Stenosis

25. A 49 year old female presents with hemoptysis over the last week. Her sputum is blood streaked. She has a cough, slight dyspnea and is concerned that she has lost 15 pounds over the last 5 weeks and is not trying to lose weight. She denies sinusitis and hematuria. She smokes a ½ pack a day and would like to quit as she is a diabetic and knows that smoking and diabetes is bad for her. Meds: no anticoagulants.

Physical exam: Vitals: stable, afebrile. HEENT: normal. Lungs: rhonchi. Heart is unremarkable.

Extremities: varicosities. Neuro: no deficits.


a. Lung Cancerb. Pneumoniac. Coagulopathyd. Wegenerse. Goodpastures

26. A 29 year old female comes to your office for evaluation of hemoptysis over the last week. She coughs up clots of blood. She also has a history of sinusitis, arthralgias and is a type II diabetic. Her current meds do not include anticoagulants.

Vital signs: BP 160/ 84. Appearance is unremarkable. Physical exam: HEENT: blood in nares.

Lungs: rhonchi. Heart: slight atrial arrhythmia. Extremities: no edema. Neuro: no deficits.


a. Goodpasturesb. Pneumoniac. Tuberculosisd. Wegenerse. Lung Cancer

27. A 23 year old male presents to the ER on your shift with hemoptysis over the past 9 hours. He states he is coughing up blood streaked, purulent stuff. His girlfriend says he has had fevers, night sweats and has lost 15 pounds over the last 7 weeks. He admits to use of alcohol and drugs, but does not take anticoagulants.

Physical exam reveals a 23 year old male, malnourished. Vitals: Temp. 101.7, Pulse 110.

HEENT: normal. Lungs: crackles. Heart: mild tachycardia, no murmurs. Neuro: no deficits


a. Pulmonary Embolusb. Tuberculosisc. Wegenersd. Goodpasturese. Congestive Heart Failure

28. A 41 year old female comes to your office with hemoptysis for the last day. She is having trouble breathing, notes a fever and has leg swelling. Her sputum is blood streaked. She has not worked in the last 5 days because of her back pain and has been resting in bed. Her meds do not include anticoagulants.

Physical exam: Mildly anxious 41 year old female. Pulse: 106. HEENT: normal.

Lungs: clear. Heart: mild tachycardia. Extremities: left calf tenderness.


a. Pulmonary Embolusb. Pneumoniac. Lung Cancerd. Coagulopathye. Wegeners

29. A 23 year old male presents to the ER with hemoptysis for the last several days. He notes trouble breathing, blood in his urine, and has had flu-like symptoms. He thinks he may be urinating less. He is concerned as he is coughing up clots of blood. He smokes, but does not take anticoagulants.

Vital signs: BP 160/90. Afebrile.

Physical exam: HEENT: normal. Lungs: rhonchi. Heart: normal, except for an occasional premature beat. Extremities: no edema. Neuro: mild anxiety.


a. Wegenersb. Coagulopathyc. Lung Cancerd. Goodpasturese. Pneumonia

30. A 49 year old female comes to your office for her routine checkup, but says she has been coughing up blood and has blood in her urine that started this morning. She has had a fever and recent easy bruising. Past medical history includes: Hypertension and cocaine dependency.

Medications include: coumadin.

Physical exam: vitals within normal limits. HEENT: blood in nares. Lungs: clear.

Heart: mild tachycardia, no murmurs. Extremities: + varicosities. Neuro: no deficits.


a. Goodpasturesb. Lung Cancerc. Pulmonary Embolusd. Wegenerse. Coagulopathy

31. A 53 year old male with hypertension presents to the ER with the sudden onset of chest discomfort. He states he was chopping wood when the pain started and it just won’t quit.

He has had the sharp chest pain for over the last 2 hours. The pain radiates to his back.

Neither exertion nor food alters his chest discomfort. No flu- like symptoms.

Physical exam reveals a 53 year old male, diaphoretic and tachypnec. Pulse 116, Resp rate 24.

BP: 160/100. Afebrile.

Lungs: clear. Heart: tachycardia and aortic regurgitant murmur. Abdomen: unremarkable. Extremities: no edema. Dermal: diaphoresis and moist extremities.


a. Anginab. Musculoskeletalc. Thoracic Aneurysmd. Pericarditise. Myocardial Infarction

. A 29 year old male presents to the ER with the sudden onset of stabbing chest pain for the last two hours. There is no radiation of the pain. He has noted flu-like symptoms three days ago and a fever. He says that walking and food do not change the pain. He denies all risk factors.

Vitals: Pulse is 130. BP: 132/84. Physical exam: Lungs: clear. Heart: precordial friction rub and tachycardia. Abdomen: Benign, not tender. Extremities: no edema. Musculoskeletal and dermal findings are unremarkable.


a. Musculoskeletalb. Pneumothoraxc. Pneumoniad. Upper GIe. Pericarditis

34. A 71 year old male comes to your office with shortness of breath for 2 days. He has dyspnea with exertion, but denies chest pain. He also admits to coughing, wheezing and orthopnea.

PMH: intermittent episodes of dyspnea without a diagnosis and frequent episodes of chest congestion. He is a long time smoker of many years and says he just can’t quit.

Vitals: Afebrile, BP: 147/100, Heart Rate: 105. Respiratory Rate: 32.

Physical exam: HEENT: unremarkable. Lungs: decreased breath sounds and increased AP diameter. Heart: tachycardic, no murmur or rubs. Extremities: no edema.

Labs: CBC: Hb 13/ HCT 41.


a. COPDb. Congestive Heart Failurec. Pneumoniad. Pulmonary Embolus

e. Pneumothorax

35. A 63 year old male presents to your office with dyspnea for 2 weeks. He denies chest pain, but has dyspnea with exertion. Other findings include: orthopnea and ankle swelling for 3 days. Past Medical history is unremarkable, but states he has a long smoking history.

Vital signs: Afebrile. BP170/60. Heart rate: 110. Respiratory rate is 32.

Physical exam: HEENT: unremarkable. Lungs: crackles and dullness to percussion.

Heart: tachycardia, no murmurs. Extremities: no edema.

Labs: H/H is 12/39.


a. Interstitial Lung Diseaseb. Anemiac. COPDd. Pleural Effusione. Pneumonia

36. A 59 year old female diagnosed with heart failure is seen in your office. She also notes ankle swelling and exertional dyspnea. She denies diabetes, Hypertension and is not a smoker.

Vital signs: Afebrile. Respirations: 22. Pulse: 72 and regular. BP: 140/80.

Physical exam: HEENT: unremarkable. Lungs: crackles.

Cardiovascular: lateral PMI, grade 3 systolic murmur at the apex, S3, normal pulse pressure

Extremities: + edema. Neurological: normal reflexes.

Workup reveals: CXR with cardiomegaly. EKG: unremarkable.

Echocardiogram reveals poor systolic function.


a. Hypothyroidismb. Aortic Regurgitationc. Mitral Regurgitationd. Hypertensive Heart Diseasee. Arrhythmia

37. A 19 year old female presents with a dry cough of 2 days. She gets these “colds” frequently, but thinks it may be from her smoking. Her cough is worse with exercise, night time and seems to be seasonal. She denies allergies. Her cough is better with her inhaler and has a family history of respiratory problems, but everyone smokes.

Vital signs: Afebrile. BP: 120/85. Resp rate: 22.

HEENT: unremarkable. Lungs: wheezing through out. Heart: no murmurs.

Abdomen: benign. Extremities: no edema.


a. Pneumoniab. Asthmac. Bronchiectasisd. Upper Respiratory Infectione. Pulmonary Embolus

38. A 63 year old male comes to the ER with a productive cough for 3 days. He has chills, fatigue and has lost a lot of weight he states. Sometimes he even coughs up some blood streaked stuff and is concerned he could have TB. He has cough with exercise. Nothing makes his cough worse, except smoking. He smokes 2 packs of cigarettes a day since he was 15 years old.

Vital signs: Afebrile. BP: 140/90. Pulse: 80. Resp Rate: 24.

Physical exam: reveals an emaciated 63 year old male.

Lungs: unilateral breath sounds. Heart: without murmur

Abdomen: Benign. Extremities: no edema.


a. Pulmonary Neoplasmb. Asthmac. Pneumoniad. Chronic Bronchitise. Upper Respiratory Infection

ccc exam 3 practice test i went through as many of the old exams

Documents

mycobacterium tb

diagnosis of tb

characteristic of tb

joint tb

pulmonary tb

mycobacterium avium

multidrug resistant

treatment of cf