Question 1

The first medication administered to a patient experiencing an anaphylactic reaction should be:

Accepted Answer

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Question 2

Your patient is a 46-year-old male who is unconscious on his front lawn after being stung by a bee. You note angioneurotic edema. HR = 132, BP = 76/40, RR = 24 and shallow. You should first:

Accepted Answer

The answer of Your patient is a 46-year-old male who...

Question 3

Which of the following statements about corticosteroid use in anaphylaxis treatment is TRUE?

Accepted Answer

Corticosteroids can help reduce the inflammation associated with anaphylaxis by suppressing the immune response and reducing swelling. However, they do not have an immediate effect on symptoms and should not be used as a first-line treatment for anaphylaxis.

Question 4

Your patient is experiencing dyspnea and urticaria after ingesting penicillin. Auscultation of his lungs reveals diffuse expiratory wheezes. Which of the following medications will best help correct your patient's bronchospasm?

Accepted Answer

Epinephrine 1:1000 SC is the best choice for reversing bronchospasm in the context of an allergic reaction to penicillin, as it has both bronchodilatory and anti-inflammatory effects.

Question 5

Which of the following best describes why the secondary response to an antigen is faster than the primary response?

Accepted Answer

The secondary response is faster because it utilizes memory cells that have already been sensitized to a specific antigen. These memory cells immediately activate and begin producing large amounts of antibodies specific to that antigen upon exposure, whereas in the primary response it takes time for the body to produce these cells and antibodies.

Question 6

Which medication would be the best choice for reducing the bronchospasm and laryngeal edema associated with anaphylaxis?

Accepted Answer

The answer of Which medication would be the best choice...

Question 7

You respond to an unresponsive patient. Upon exam, you get a finger stick blood glucose reading of "Lo." Treatment should include administration of:

Accepted Answer

A finger stick blood glucose reading of "Lo" typically indicates severe hypoglycemia, which should be treated with administration of dextrose to rapidly elevate the patient's blood sugar levels. Insulin would worsen the hypoglycemia, epinephrine is indicated for anaphylaxis or severe allergic reactions, and ASA is indicated for chest pain or suspected heart attack.

Question 8

Upon identifying an antigen in the bloodstream, B cells launch a chemical attack by producing antigens specific to the antibody. This is an example of ________ immunity.

Accepted Answer

This is an example of humoral immunity, where B cells produce antibodies specific to the antigen to combat it in the bloodstream.

Question 9

Diphenhydramine is administered in anaphylaxis because it:

Accepted Answer

Diphenhydramine produces all of the above effects, including blocking histamine receptors, being nonselective, and reducing histamine release from mast cells and basophils.

Question 10

Which sign associated with an allergic reaction should concern a caregiver the most?

Accepted Answer

Wheezing may indicate a severe allergic reaction or anaphylaxis, which can be life-threatening if not treated immediately. It is important for the caregiver to seek emergency medical care if wheezing occurs. Urticaria, warm flushed skin, and GI distress are common allergic reaction symptoms and can be treated with antihistamines or other medications.

Question 11

Which of the following treatment regimens for anaphylaxis lists the medications in the correct order of administration following oxygen?

Accepted Answer

Epinephrine is the first-line treatment for anaphylaxis and should be administered immediately after ensuring the airway and giving oxygen. Diphenhydramine and dexamethasone are adjunctive treatments that can be given after epinephrine to help manage symptoms and prevent biphasic reactions.

Question 12

Which of the following statements about the use of vasopressors in the treatment of anaphylaxis is TRUE?

Accepted Answer

The answer of Which of the following statements about the...

Question 13

Which treatment would best halt the urticaria associated with an allergic reaction?

Accepted Answer

Epinephrine and diphenhydramine are the standard treatment for halting urticaria associated with an allergic reaction. Epinephrine can quickly reduce the severity of the reaction while diphenhydramine can help relieve itching and other symptoms. Solu-Medrol, oxygen, dopamine and albuterol are not typically used for the treatment of urticaria.

Question 14

Your patient is experiencing profuse hives, itching, dyspnea, coughing, tachycardia, and dizziness after eating seafood 5 minutes ago. You might also expect to see all of the following additional signs EXCEPT:

Accepted Answer

Hypotension, not hypertension, is often seen in anaphylaxis due to the rapid dilation of blood vessels.

Question 15

Epinephrine administration results in all of the following EXCEPT:

Accepted Answer

Epinephrine is a sympathomimetic drug that acts on alpha and beta-adrenergic receptors. It increases heart rate, cardiac contractile force, and peripheral vasoconstriction. Hypotension is not a side effect of epinephrine administration, as it constricts blood vessels and increases blood pressure.

Question 16

A male patient presents with a puncture wound to his heel from stepping on a nail. He informs you that he is visiting from El Salvador and has never received a tetanus vaccination. At the emergency room he is administered tetanus immune globulin, as well as a tetanus vaccination. Which of the following best describes the rationale for this treatment?

Accepted Answer

The tetanus immune globulin provides passive immunity, meaning immediate protection through the injection of pre-formed tetanus-specific antibodies. The tetanus vaccination, on the other hand, provides active immunity by stimulating the patient's own immune system to produce its own tetanus-specific antibodies, providing long-term protection. In this case, both forms of immunity are needed to protect the patient from tetanus infection.

Question 17

You respond to an ill type 2 diabetic patient. Upon your arrival, the patient complains of not feeling well for a few days, and increasing blood glucose levels. You suspect:

Accepted Answer

The patient's symptoms suggest Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNK), which is a severe complication of uncontrolled diabetes that can lead to dehydration, hyperglycemia, and altered mental status but does not typically involve the presence of ketones in the blood as seen in diabetic ketoacidosis (DKA). TNK and TPA are not relevant to this patient's presentation as they are medications used for clot-busting therapy in stroke and heart attack patients respectively.

Question 18

Which of the following is the desired physiologic reaction that occurs after the administration of a vaccine that contains live, attenuated viruses?

Accepted Answer

The desired physiologic reaction after the administration of a vaccine that contains live, attenuated viruses is for the immune system to create specific antibodies to the viruses in the vaccine. This allows the body to recognize and mount a defense against the actual virus if it is encountered in the future. Option A is incorrect because antibodies themselves do not multiply, but rather the cells that produce them. Option C is incorrect because the immune system does not create antigens; antigens are substances that stimulate an immune response. Option D is incorrect because the immune response stimulated by a live, attenuated virus vaccine is specific, not nonspecific.

Question 19

Your patient is a 36-year-old female, conscious and alert, sitting at her desk and complaining of a rash and itchiness after taking a sulfa antibiotic. Physical examination reveals warm and dry skin, urticaria on her chest and back, lung sounds that are clear and equal bilaterally. HR = 100, BP = 132/78, RR = 14, SaO₂ = 98%. Which of the following is the most appropriate treatment for this patient?

Accepted Answer

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Question 20

Your patient is a conscious and alert 22-year-old female who was stung by a hornet. She states that she has "allergies to bee stings" and has been told that she could die if stung. Your physical examination reveals a 1-cm-diameter, red, edematous area where she was stung on the left forearm. Her skin is warm and dry, and her lung sounds are clear and equal bilaterally. HR = 12 and regular, BP = 122/82, RR = 12 and regular, SaO₂ = 98%. The most appropriate treatment for this patient would include:

Accepted Answer

The answer of Your patient is a conscious and alert...

Quiz 3: Pulmonology