1.

When evaluating a patient with a pleural effusion, what are the differences between an
exudate and transudate?
Transudate

Specific gravity
Protein content
Cellularity

Causes

2. Match the pneumoconiosis to the corresponding findings.

Pneumoconiosis

Findings
Associated with shipbuilding, roofing,
plumbing, brake mechanics

Associated with foundries (casting metal),

sandblasting and mining
Associated with coal mines, large urban
centers and tobacco smoke

Associated with exposure in the nuclear and

aerospace industry

3. A 47-year-old obese man comes to the physician for sleeping problems. The patients wife
reports that he snores very loudly and stops breathing several times at night.
a.
b.
c.
d.

What are some clinical manifestations of obstructive sleep apnea (OSA)?

What are the risk factors?
What is the first-line diagnostic study for OSA?
What are the treatments for OSA?

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INTERNAL MEDICINE

Exudate

IM - PULMONOLOGY SET

IM - PULMONOLOGY SET

IM - PULMONOLOGY SET

4. A 72-year-old man complains of occasional mild shortness of breath and a frequent, nonproductive cough. He has smoked 2 packs of cigarettes daily for 45 years. On examination
he has diminished breath sounds diffusely. Pulmonary function tests are performed and his
FEV1 is 48% of predicted. What is the most appropriate treatment for this patient?

5. A 34-year-old man is in the hospital for sepsis that began from a severe cellulitis in the
lower extremities. Over the course of several days his status starts to worsen, and he develops
severe shortness of breath and decreased responsiveness. He becomes hypoxemic, and a
chest x-ray shows bilateral pulmonary edema. His brain natriuretic peptide is normal. He
has a normal echocardiogram. The patient has to be intubated and placed on mechanical
ventilation. What other treatments are most appropriate at this time?

6. A 62-year-old woman has a 7-mm, solid, solitary pulmonary nodule in the left lower lung.
The woman has no smoking history, but she does have a family history of lung cancer. What
is the most appropriate management for this patient?

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8. A 68-year-old man has idiopathic pulmonary hypertension. He is currently taking

furosemide, diltiazem and is on supplemental oxygen. His pulmonary artery pressure is
stable. What other treatment should be added to this patients regimen?

9. A 21-year-old man comes to the physician for a nonproductive cough, fever and myalgias
for the past 4 days. His symptoms began abruptly but he denies any dyspnea or other
severe respiratory symptoms. He has no other medical problems. His examination reveals
rhinorrhea but his lungs are clear. A rapid influenzae screen is positive. What is the most
appropriate treatment for this patient?

10. What is the treatment for each of the following pulmonary infections?
a. Histoplasmosis
b. Blastomycosis
c. Coccidioidomycosis

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INTERNAL MEDICINE

IM - PULMONOLOGY SET

7. A 42-year-old woman has pulmonary sarcoidosis with no known extrapulmonary

involvement. She denies any current respiratory symptoms, but her most recent chest CT
reveals bilateral hilar adenopathy and reticular opacities in the upper lobes. What is the most
appropriate management for this patient?