Pulmonary Board Review Take Home Quiz - Answers
1. What are the classic CBC findings in pertussis? Elevated WBCs with lymphocytosis.
2. Describe how pulmonary sequestration, CCAM, and bronchogenic cyst may appear different on imaging.
Sequestration is dense opacification, most commonly along diaphragm. If extralobar, may be beneath diaphragm or
retroperiotoneal. Bronchogenic cyst and CCAM will each have cystic components which may be air filled lucencies within
a dense structure. Bronchogenic cysts will be more centrally located.
3. Compare and contrast Primary Ciliary Dyskinesia (Kartagener Syn) and Cystic Fibrosis.
Both Kartageners and CF can have nasal polyps, infertility, clubbing, and recurrent sinopulmonary infections. Only 50%
of Kartageners have situs inversus. OM more common problem in Kartageners. CF would likely be short stature and have
some degree of malabsorption.
4. What is the classic clinical presentation and CXR findings in patient with vascular ring?
Infant with progressive stridor, ronchi, exp wheeze, feeding difficulties, recurrent LRTI. CXR: right sided aortic arch with
tracheal deviation to left.
5. Describe classic presentation of vocal cord dysfunction. How can it be confirmed?
Adolescent female, high performing, sudden onset episodes of wheezing, SOB, dsypnea. May be brought on by
competitive or stressful event. Feeling of trouble getting air in, localized to throat. Clinical diagnosis, but may be
confimed by direct visualization of cords or PFT’s.
6. What are the common clinical presentations of cystic fibrosis?
See Table 16-6 on page 613
7. What are the common complications you may encounter when seeing a patient with cystic fibrosis?
Hypochloremic metabolic alkalosis, hemoptysis, pneumothorax, pneumomediastinum, hypertrophic pulmonary
osteoarthropathy, distal intestinal obstructive syndrome, biliary cirrhosis, pancreatitis, cor pulmonale, respiratory failure
8. Define the following:
A. SIDS – unexpected death of an infant younger than 1 year of age who has been otherwise healthy and in
whom there is no demonstrable pathologic basis for death as determined by a thorough postmortem
examination and death scene investigation.
B. ALTE – a witnessed event that is frightening to the observer and that is characterized by some combination of
apnea, color change, marked change in muscle tone, choking or gagging. The obsterver geels that the vent
would have resulted in the infant’s death had he or she not intervened.
C. Apnea – absence of airflow for at least 20secs or apnea accompanied by cyanosis or bradycardia
D. Obstructive apnea – lack of airflow at the nose or mouth despite continued respiratory efforts
E. Central apnea – absence of airflow accompanied by the cessation of chest and abdominal wall movement
9. Name the risk factors that place a child at risk for aspiration.
Neurologic impairment, incoordination of swallowing, GER, delayed gastric emptying
10. Name the indications and contraindication to performing flexible bronchoscopy.
Indications – stridor, unexplained or chronic cough or wheeze, suspected airway malformations or compression,
atelectasis or recurrent PNA, unexplained PNA, transbronchial biopsy post transplant
Contraindication – Suspected foreign body