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surgery E. Protozoan infection
D. Surgical therapy is reserved for
those patients who develop 382. Which diseases can cause
severe hemoptysis, empyema of the pleura: 1.
bronchopleural fistula or Parapneumonic effusion; 2. Congestive
empyema heart failure; 3. Lung abscess cavity
E. Pulmonary resection is erodes into a pleural space; 4.
warranted if the abscess cavity is Tuberculosis; 5. Collagen-vascular
larger than 6 cm in diameter for disease.
more than 8 weeks of aggressive A. 1, 3, 4
antibiotic therapy B. 1, 2, 4
C. 1, 4, 5
379. After suffering a severe bout of D. 2, 3, 4
pneumonia, a 46-year-old renal E. 3, 4, 5
transplantation patient develops a lung
abscess. She has been receiving 383. Choose correct principles in
immunosuppression therapy since her treatment of empyema: 1. Complete
last kidney transplantation 3 years ago. evacuation of the content of
What is the most appropriate infected space; 2. Elimination of
treatment? cavity; 3. Control of causative
A. Needle aspiration organisms/sterilisation; 4. Nutritional
B. Urgent thoracotomy support; 5. Ventilation support:
C. Antituberculous therapy A. 1, 2, 3
D. Antibiotics and vigorous B. 2, 3, 4
attempts to obtain bronchial C. 1, 4, 5
drainage D. 3, 4, 5
E. Insertion of an intercostal pleural E. All are correct
drin
384. Which microbiological aspect is
not correct concerning empyema:
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A. 5-10% of parapneumonic B. Each lung is divided into lobes
effusions become empyema C. The right lung has 3 lobes
B. A lack of detectable causative D. The left lung has 2 lobes
organisms reported not more E. Each segment is further divided
then 10% into lobes.
C. Blood cultures positive in only
10% of patients 387. The most often pleural effusion is
D. Community acquired empyema caused by all of the following,
most oftenly is caused by EXCEPT:
Streptococcus pneumoniae A. Congestive heart failure
E. Hospital-acquired empyema B. Malignancy
most oftenly is caused by C. Infections
Staphylococcus aureus D. Pulmonary embolism
E. Chronic obstructive pulmonary
385. Immediately following a bout of deseases
pneumonia, a young woman develops a
large pleural effusion. A chest tube is 388. What is the most common
inserted and 600 mL of thin pus is symptom associated with pleural
obtained. A CAT scan shows effusion?
incomplete drainage and multiple A. Dyspnea
intrapleural loculations. Management B. Caugh
of this empyema requires: C. Pain
A. Insertion of multiple chest D. Diffuse edema
tubes under CAT guidance to E. Anaemia
drain either most or all
loculations 389. Physical examination is
B. Treat the patient with NOT informative until pleural
antibiotics and continue single effusion exceeds:
chest tube drainage A. 100 mL
C. Treat patient with antibiotics B. 300 mL
and continue single chest tube C. 30 mL
drainage waiting for a thick D. 1000 mL
peel to develop and then E. 2500 mL
proceed with open total lung
decortication 390. In the case of pleural
D. Proceed with thoracoscopy and effusion physical findings include
intrapleural toilette. Break the all of the following, EXCEPT:
loculations and place drains A. Decreased breath sounds
E. A thorough open total lung B. Dullness to percussion
decortication immediately C. Decreased tactile fremitus
D. Bronchial breath sounds
386. Which statements are E. Pleural friction rub
NOT true?
A. The lungs occupy most of the 391. Transudates are caused by
volume of each hemithorax a small, defined group of etiologies,
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including the following: 1). malignancy; 5). Mechanical
Congestive heart failure, 2). Spread ventilation
TB infection, 3). Atelectasis due to A. 1,2,5
malignancy or pulmonary B. 1,2,4
embolism, 4). Hypoalbuminemia, C. 1,3,4
5). Congenital lung deseases. D. 2,3,5
A. 1,2,3 E. 3,4,5
B. 1,3,4
C. 1,4,5 395. Complications of
D. 2,3,5 diagnostic thoracentesis include:
E. 2,4,5 1). Internal bleeding; 2). Systemic
hypotension; 3). Pneumothorax;
392. The most common causes of 4). Fistula formation; 5). Spleen or
exudates include the following: 1). liver puncture
Congestive heart failure, 2). A. 1,3,5
Pulmonary embolism, 3). B. 1,2,4
Esophageal perforation, 4). C. 1,3,4
Myxedema, 5). Chylothorax D. 2,3,5
A. 1,2,3 E. 2,4,5
B. 1,3,4
C. 1,4,5 396. The recommended limit
D. 2,3,5 in a single thoracentesis procedure
E. 2,4,5 is:
A. 1000-1500 mL
393. Choose indications for diagnostic B. 150-200 mL
thoracentesis from the following: 1). C. 300-450 mL
Etiology of the effusion is unclear; D. 600-7500 mL
2). Effusion does not respond to E. 50-100 mL
therapy as expected; 3). Small
amoung of effusion in clinically 397. Pleurodesis is most
stable patients; 4). Underlying oftenly used for:
congestive heart failure; 5). A. Recurrent malignant effusions
Suspected malignancy B. Spreading TB infection
A. 1,2,5 C. COPD associated with pleural
B. 1,2,3 effusion
C. 1,4,5 D. If diagnosis of pyopneumothorax
D. 2,3,4 is confirmed
E. 3,4,5 E. Empiema associated with lung
abscess
394. Name contraindications
for diagnostic thoracentesis: 1). 398. Surgical intervention is
Pulmonary hypertension; 2). Small most oftenly required for:
volume of fluid; 3). A. Parapneumonic effusions that
Hypocoagulation; 4). Suspected cannot be drained adequately by
needle
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B. Lung abscess development after 402. Definition of lung
pneumonia abscess includes all, except: [ Pobierz całość w formacie PDF ]