MD - Doctor of Medicine Pulmonary Disease Management Questions and Answers

Question 1

A 68-year-old male with a significant smoking history presents with increased dyspnea, cough, and sputum production.
His baseline is managed with a LAMA/LABA inhaler.
He has had two moderate exacerbations in the past year.
According to the most recent GOLD guidelines, what is the most appropriate next step in managing his stable COPD?

Accepted Answer

Add an inhaled corticosteroid (ICS) to his current regimen.

Answer

Switch to a short-acting beta-agonist (SABA) as needed.

Answer

Initiate long-term oral corticosteroid therapy.

Answer

Prescribe a daily macrolide antibiotic.

Question 2

A 45-year-old female presents to the emergency department with a severe asthma exacerbation, refractory to initial treatment with nebulized albuterol/ipratropium and systemic corticosteroids. She is tachypneic and speaking in single words. Which of the following intravenous medications is most appropriate to administer as an adjunctive therapy in this situation?

Accepted Answer

Magnesium sulfate

Answer

Furosemide

Answer

Aminophylline

Answer

Sodium bicarbonate

Question 3

A 72-year-old patient is being evaluated for suspected idiopathic pulmonary fibrosis (IPF). Which of the following findings on high-resolution computed tomography (HRCT) of the chest is most characteristic of a 'definite UIP' (Usual Interstitial Pneumonia) pattern, often allowing for a confident diagnosis of IPF without a lung biopsy?

Accepted Answer

Subpleural, basal predominant honeycombing and traction bronchiectasis.

Answer

Predominantly upper lobe ground-glass opacities and micronodules.

Answer

Widespread consolidation and pleural effusions.

Answer

Peribronchovascular-centered reticulation with sparing of the subpleural lung.

Question 4

A 65-year-old man presents with a 3-day history of fever, productive cough, and shortness of breath. A chest x-ray confirms a right lower lobe infiltrate. His vitals are: RR 32/min, BP 88/55 mmHg, and he is newly confused. His BUN is 25 mg/dL. Based on the CURB-65 score, what is the most appropriate management setting for this patient with community-acquired pneumonia (CAP)?

Accepted Answer

Inpatient hospital admission, likely to the ICU.

Answer

Outpatient management with oral antibiotics.

Answer

Inpatient hospital admission to a general medical ward.

Answer

Consideration for outpatient management with close follow-up.

Question 5

Which of the following is considered the first-line and most effective treatment for most patients with moderate to severe obstructive sleep apnea (OSA)?

Accepted Answer

Continuous Positive Airway Pressure (CPAP)

Answer

Mandibular advancement device

Answer

Uvulopalatopharyngoplasty (UPPP)

Answer

Weight loss and positional therapy

Question 6

A 55-year-old woman is newly diagnosed with Pulmonary Arterial Hypertension (PAH), classified as low-to-intermediate risk. She has no significant comorbidities. According to current treatment guidelines, what is the recommended initial therapeutic strategy?

Accepted Answer

Initial combination therapy with an ERA and a PDE-5 inhibitor.

Answer

Monotherapy with a calcium channel blocker.

Answer

Monotherapy with an endothelin receptor antagonist (ERA).

Answer

Immediate referral for lung transplantation evaluation.