PULM MKSAP EXAM QUESTIONS AND ANSWERS 2024

52 yo F with productive cough and clear sputum worsened in last 3 days and albuterol inhaler up to 4
times daily - Admit pt to hospital for inpatient management
Labs reveal IGE Of 265 and 10% eosinophils - Discontinue Ibuprofen, give prednisone
Which of the following long term meds will reduce COPD exacerbations - Roflumilast
57 yo M daytime sleepiness, loud snoring, daytime pauses. Most appropriate management? - Home
sleep testing
Patient undergoes follow up of his lung at 12 months and at 2 years. The nodule is unchanged. Most
appropriate mgt? - Chest CT scans every 2 years for 5 years
72 yo M high res CT shows new bilateral ground glass opacities with bronchiectasis and honeycomb
changes. Most likely dx? - Acute exacerbation of IPF
32 yo M evaluated for sx of persistent asthma. Upper chest and throat tightness. Most appropriate mgt?
- Laryngoscopy
56 yo M hispitalized for respiratory failure evaluated for new onset confusion. Most appropriate
management? - Early mobilization
Smoker. Most likely to improve survival? - Tobacco cessation
56 yo M hospitalized for hematemesis. Vomited bright red blood, cirrhosis and alcohol use. What should
be done next? - Insert an endotracheal tube
30 yo M presents for a refill on his albuterol. Most appropriate tx? - Beclomethasone
72 yo M, no hx of dry eyes, dry mouth, or dry nose, Raynauds, or arthritis. Most likely dx? - IPF
38 yo F evaluated for fevers, myalgia, and confusion. Returned from camping trip in woods 5 days ago. -
No additional testing
67 yo M 3 day hx of weakness and nausea and 2 week hx of difficulty swallowing. 50 lb weight loss. Most
likely dx? - Small cell lung cancer
62 yo F evaluated in ED for worsening DOE for last 2 weeks. Labs show arterial PCO2 of 46. Most
appropriate next additional test? - ECG
62 yo M evaluated for sleep apnea. Which of the patients conditions is the strongest indication for
positive airway pressure therapy? - Excessive daytime sleepiness
39 yo M with obesity hypoventilation syndrome is hospitalized for hypoxemia and AMS. Three hours ago
placed on bipap. Most appropriate treatment? - Endotracheal intubation
42 yo M progressive dyspnea over 2 years. Now sx when walking up stairs. 1 py hx. Most appropriate test
to perform next? - Alpha-1-anyitrypsin
46 yo M with problems auto adjusting positive airway pressure therapy. Most appropriate treatment? -
Heated humidificafion
49 yo F in office for recent hospitalization for an asthma exacerbation. 650 eosinophils and IGE level is
12. Most appropriate treatment? - Initiate a trial of Mepolizumab therapy
79 yo F brought in by neighbor after being found unconscious. Using propane. - Hyperbaric oxygen
therapy
55 yo M in COPD exacerbation. Doing well until 3 days ago when he developed fevers, myalgia, increased
cough, production of yellow sputum. Most appropriate diagnosis test? - ABG