2025 NYS Thoracic Society Post-Test Questionnaire

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Post-Test Questionnaire **Must complete to received CME credit**

Linda Rogers, MD

Moving Beyond “Treat to Fail”: Asthma Remission as a Treatment Goal

Which of the following treatments have been shown to reduce exacerbations of asthma at GINA Step3/Step4?

1 point

Fixed dose and as needed use of ICS-formoterol combination inhaler up to 12 puffs per day

addition of budesonide-albuterol OR inhaled beclomethasone whenever SABA is used for quick relief to a wide range of background controller treatments

A and B

Neither of these treatments

Anna Podolanczuk, MD, MS

Interstitial Lung Abnormalities: State of the Art

Interstitial lung abnormalities are defined by which of the following features?

1 point

Ground glass opacities

Reticular abnormalities

Traction bronchiectasis

Honeycombing

All of the above

Philip J. Choi, MD

How I do it: Home Mechanical Ventilation

Which of the following is NOT a feature found exclusively on home ventilators?

1 point

Volume Assured Pressure Support (VAPS)

Volume Assured Pressure Support with Auto-EPAP (VAPS-AE)

Mouthpiece ventilation

Internal and external batteries

Erica Altschul, DO

Pulmonary Hypertension for the General Pulmonologist

What is/are the current FDA approved treatment(s) for WHO Group 3 pulmonary hypertension due to Interstitial Lung Disease

1 point

Mean pulmonary artery pressure > 30, pulmonary capillary wedge pressure >18, pulmonary vascular resistance > 3WU

Systolic pulmonary artery pressure > 25, pulmonary capillary wedge pressure >15, pulmonary vascular resistance > 3WU

Mean pulmonary artery pressure > 20, pulmonary capillary wedge pressure > 15, pulmonary vascular resistance > 2WU

Systolic pulmonary artery pressure > 30, pulmonary capillary wedge pressure > 15, pulmonary vascular resistance > 2WU

There is no defined criteria for post capillary pulmonary hypertension

Anne E. O’Donnell MD

Trudeau Lecture: New Frontiers in Bronchiectasis

Of the following, which test should be routinely performed in all bronchiectasis patients?

1 point

Sputum cultures

Modified barium swallow

Cardiopulmonary exercise testing

Bronchoprovocation testing

Alison Lee, MD

Environmental Exposure and Respiratory Health

An 8-year old girl with a history of asthma presents to the emergency room with increased shortness of breath and cough. Her mother reports that her symptoms began overnight and worsened throughout the morning, despite implementation of her single inhaler maintenance and reliever therapy (SMART) asthma action plan.

Her mother reports that her daughter takes her maintenance budesonide/formoterol with spacer as prescribed and is up to date on her vaccinations, including annual influenza vaccination and COVID-19 booster. She has no known sick contacts. Her mother notes that her home environment has been discussed with her pediatrician and there are no carpets, pets or visible mold, her daughter sleeps on hypoallergenic bedding, there are no smokers in the household. On further questioning, you learn that the family lives next to a major roadway that is a truck route and the daughter’s asthma control has worsening significantly since the family moved in a year ago.

On exam, she is afebrile but tachycardic and tachypneic with diffuse inspiratory and expiratory wheezing and notable accessory muscle use. You begin proper medical therapy.

Which of the following is the most likely contributing cause of the patient’s asthma exacerbation?

1 point

Influenza infection

Traffic-related air pollution

Poor medication adherence

Respiratory syncytial virus infection

Gabriela Magda, MD, Hilary J. Goldberg, MD, MPH, Jake G. Natalini, MD, MSc

Expert Panel: Evolutions in Lung Transplant

A 63-yo man with IPF is referred for lung transplant. His FVC is 1.64L (45.4%) and he requires 2LPM only with exertion. He is lost to follow-up. 7 months later he returns to clinic with FVC 1.22L (33.9%) and requiring 4LPM O2 at rest. He undergoes expedited lung transplant evaluation. On LHC he is found to have 3V CAD with nml LV function: mid-LAD 100% stenosed, LCX 1st marginal 90% stenosed, mid-RCA 80% stenosed, and distal RCA 90% stenosed. His mid-LAD lesion is notable for chronic occlusion. Which of the following is the next best step in management?

1 point

Refer the patient to palliative care and tell him his 3V disease renders him too high risk for lung transplant

Approve patient for listing for lung transplant and concomitant CABG x 3

PCI to the RCA and LCX with minimum 3 months DAPT, and plan for non-surgical revascularization of LAD pre-transplant

PCI to the RCA and LCX with minimum 6 months DAPT, and plan for non-surgical revascularization of LAD pre-transplant

PCI to the RCA and LCX with minimum 3 months DAPT, and plan for CABG x 1 at the time of transplant

Which of the following is not a recommended component of the psychosocial assessment of candidates for cardiothoracic transplantation? *

1 point

Assessment of adherence to medical treatment

Assessment of social supports

Language barriers

Cognitive status/capacity

History of mood or anxiety disorders

A 57-year-old man undergoes bilateral lung transplantation for idiopathic pulmonary fibrosis off cardiopulmonary bypass. His postoperative course is complicated by severe hypoxemic respiratory failure with a PaO2 of 100 mmHg despite mechanical ventilation with an FiO2 of 80% and PEEP of 10 cm H2O. His chest radiographic shows bilateral airspace opacities. A bronchoscopy with BAL is performed, and bacterial cultures are negative. Which of the following is the most appropriate next step? *

1 point

Transesophageal echocardiography to examine the patency of the pulmonary venous anastomoses

Empiric initiation of treatment-dose IV ganciclovir while awaiting serum CMV PCR testing

Initiation of broad-spectrum antibiotics for presumed ventilator-associated pneumonia

Implementation of low tidal volume ventilation and administration of inhaled nitric oxide

Administration of IV bumetanide and chlorothiazide

Nida Qadir, MD

Updates in ARDS

Which of the following measures is associated with increased mortality in patients with early severe ARDS?

1 point

Neuromuscular blockade

Sustained recruitment maneuvers

Corticosteroids

Inhaled nitric oxide

Jakob I. McSparron MD

Survival Stories: Management after the ICU

True of false: The majority of patient who survive ARDS have spirometry impairment to less than 50% of predicted values six months after their illness.

1 point

True

False

Avraham Z. Cooper, MD

Intensity and Intentionality: Teaching in the ICU

What are barriers to teaching in the ICU?

1 point

High patient acuity

Frequent team composition turnover

Learner fatigue

All of the above

Paritosh Prasad MD MBA DTM&H

Updates on Acute Chronic Liver Failure

What the is the optimal initial management to avoid impending death in a patient with no preceding medical issues presenting with acute acetaminophen overdose with elevated acetaminophen level, jaundice, marked transaminitis, elevated INR, now with acutely deteriorating mental status with ammonia of 200meq/dL?

1 point

Initiation of N-acetyl-cysteine

Immediate transfer to a liver transplant center

Paracentesis for cell counts with differential and culture and start Piperacillin-Tazobactram

Start enteral and rectal lactulose

Initiate continuous veno-venous hemofiltration.

Corrina Oxford-Horrey, MD

Critical Illness in Obstetric Patients

What happens to lactate levels during labor?

1 point

Increases

Decreases

Labor does not change lactate levels

Normative data on lactate levels with labor are not published

Lauren Ferrante, MD, MHS

Improving the Care and Outcomes of Critically Ill Older Adults

What health outcome “matters most” to a majority of older adults and the general ICU population?

1 point

Staying alive

Pain relief

Maintaining functional independence

Symptom relief

Avoiding readmissions

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