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Clinical Review Quiz

Acute Chest Syndrome

Aaron W. Bernard, MD

Dr. Bernard is a resident physician, Department of Emergency Medicine, University Hospital, University of Cincinnati, OH.

The questions below are based on the article
“Acute Chest Syndrome”.

Choose the single best answer for each question.

1. Which of the following are believed to be the most common causes of acute chest syndrome (ACS)?
  1. Excessive narcotic administration and excessive hydration
  2. Fat emboli and infection
  3. Infection and excessive hydration
  4. Rib infarction and infection
  5. Thromboembolism and rib infarction
Click here to compare your answer.

2. Which of the following organisms are the most common infectious causes of ACS?

  1. Chlamydia pneumoniae and Mycoplasma pneumoniae
  2. Klebsiella pneumoniae and influenza virus
  3. Staphylococcus aureus and respiratory syncytial virus
  4. Streptococcus pneumoniae and Klebsiella pneumoniae
  5. Streptococcus pneumoniae and Mycoplasma pneumoniae
Click here to compare your answer.

3. What are the most common presenting symptoms of ACS in children?

  1. Chest pain and fever
  2. Cough and hemoptysis
  3. Fever and cough
  4. Hemoptysis and extremity pain
  5. Shortness of breath and chest pain
Click here to compare your answer.

4. Which laboratory abnormality is associated with worse outcomes in patients with ACS?

  1. Decreased hemoglobin concentration
  2. Decreased platelet count
  3. Decreased potassium level
  4. Elevated sodium level
  5. Elevated white blood cell count
Click here to compare your answer .

5. Which of the following is NOT a treatment modality for ACS?
  1. Antibiotics
  2. Bronchodilators
  3. Incentive spirometry
  4. Nitroglycerin
  5. Transfusion therapy
Click here to compare your answer.

6. Which therapy initiated in patients with painful crisis upon admission to the hospital has been shown to decrease the incidence of ACS?

  1. Antibiotics
  2. Corticosteroids
  3. Hydroxyurea
  4. Incentive spirometry
  5. Nitric oxide
Click here to compare your answer.

7. Which of the following are TRUE statements regarding chest radiography and ACS?

  1. A new infiltrate on chest radiograph in conjunction with one other clinical sign or symptom (chest pain, cough, fever, wheezing, tachypnea) defines ACS
  2. The clinical severity of disease and the patient’s degree of hypoxia may not be appreciated on the initial chest radiograph
  3. A single negative chest radiograph excludes the diagnosis of ACS
  4. A and B
  5. All of the above
Click here to compare your answer.


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