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AG-ACNP Boards Exam - Questions And Verified Answers
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AG-ACNP Boards Exam - Questions And Verified Answers
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AG-ACNP Boards Exam - Questions And VerifiedAnswers
Your patient is intubated on the following settings: SIMV/FiO2 .6/PEEP 5. You
notice shunting. What should your next action be? Right Ans - Increase
PEEP from 5 to 10 to recruit alveoli and increase surface area to improve
oxygenation
Which drugs are associated with the BBW - Do not take during acute asthma
exacerbation? Right Ans - Long acting beta-2 agonists
Antileukotrienes
What is the inpatient management of an acute asthma attack? Right Ans -
O2
IVF
ABG
Albuterol 0.3 cc in 3 mL NSS q30-60 mins
Corticosteroids - Methylprednisolone 60-125 mg IV x 1 then 20 mg IV q4-6
hrs
Anticholinergic - Atrovent MDI 2-6 puffs q4-6 hrs
Define status asthmaticus. Right Ans - Severe, acute asthma that is
unremitting and poorly responsive.
What are the gold standard interventions for status asthmaticus? Right Ans
- IV D51/2NS
Intubation
Cont. pulse ox
ABG q 10-20 min
32 yo. M with PMH significant for mitral valve replacement now complains of
wheezing during physical activity 2-3 times/week. What should you do next?
Right Ans - Send patient for pulmonary function testing.
What is the pathology of asthma? Right Ans - Increased
responsiveness/hyperresponsiveness of the trachea and bronchi to a stimuli.
Acute inflammation
Narrowing of airways
, Hypertrophy of smooth muscle
Mucosal plugging of airways
What are the hallmark signs and symptoms of asthma? Right Ans -
Respiratory distress at rest
Difficulty speaking in sentences
RR > 28
Pulsus paradoxus > 12 mmHg
What PFT value is suggestive of an obstructive disease? Right Ans -
Decreased FEV1
Which acid-base imbalance is associated with asthma? Right Ans -
Respiratory Alkalosis with mild hypoxemia
What PFT values would indicate hospitalization of an asthmatic patient?
Right Ans - Decreased FEV1 <30% predicted OR
does not increase to at least 40% predicted after 1 hr.
Peak flow is <60 L/min initially OR does not increase to >50% predicted after
1 hr tx
What are the ominous findings associated with an asthma exacerbation?
Right Ans - Extreme fatigue
Lethargy
ABG - hypercapnea >pCO2 >45 mmHg = EMERGENCY
What is the outpatient daily management drug for asthma? Right Ans -
Inhaled Corticosteroids - Budesonide (Pulmicort)
58 yo. M presents to ED with complaints of dry cough. CXR revealed
generalized, inflamed film throughout. What is the most likely diagnosis?
Right Ans - Pneumonitis
What drug has been known to prevent nosocomial PNA? Right Ans -
Sulcarafate (Carafate) - Mucosal Protective Agent
What is an initial finding associated with a pulmonary embolism? Right
Ans - Respiratory Alkalosis - secondary to increased RR and blowing off CO2
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