Answer and Explanation 25

25.  The correct answer is D.   Metoprolol has the greatest beta 1 selectivity.  Bisoprolol and Atenolol have more beta 1 receptor selectivity than Propranolol.  Propranolol is most likely to cause bronchospasm out of the group of beta blockers.

Question 25

25.  Which of the following beta blockers is less likely to cause bronchospasm?

A.  Propranolol

B.  Atenolol

C.  Bisoprolol

D.  Metoprolol

Answer and Explanation 24

24.  C is the correct answer.  Amiodarone patients should be monitored for this.  They can be sent for diffusion studies (DLCO) that can be done with pulmonary function tests.  Lisinopril an ACE inhibitor can cause a dry cough in 5% of patients that take them because of elevated bradykinin levels.  Coreg does not really have any significant side effects than rarely bronchospasm.  Diltazem does not have any significant pulmonary side effects.

Question 24

24.   Which of the following medications have a potential adverse reaction of pulmonary toxicity and impaired diffusion across the alveolar capillary membrane?

A.  Lisinopril

B.  Coreg

C.  Amiodarone

D.  Diltazem

Answer and Explanation 23

23.  D is the correct answer.  You would not expect to hear crackle on a patient with a moderate right side effusion. You would expect to her decreased or absent breath sounds.  You would also hear dullness to percussion.

Question 23

23.  Your patient is a 88 year old male that comes in with shortness of breath progressively worse over the last couple weeks.  His chest X Ray reveals a moderate side pleural effusion.  Which of the following physical findings does not correlate with the x ray findings?

A.   Dullness to percussion in right lower lobe

B.  Diminished breath sounds right lower lobe

C.  Absent sound on the right side

D.  Rales in the right lower lobe