NY State Thoracic Society Post-Test Questionnaire
**N/A can be used for any lecture not attended**
Speaker: Mark Metersky, MD
Lecture Title: Therapies in Non-CF Bronchiectasis: Where is the Evidence?
How many therapies are FDA approved for the treatment of bronchiectasis?
What is the only therapy for bronchiectasis supported by clear cut evidence from randomized clinical trials?
Chronic macrolide therapy
Hypertonic saline nebulization
Speaker: Lynn Tanoue, MD
Lecture Title: What Pulmonologists Need to Know About the 8th Edition of the Lung Cancer Staging System
A 65-year-old man presents for evaluation of a right lower lobe nodule identified during evaluation for persistent cough. He otherwise feels well and has no other complaints. PMHx: 25 pack years smoking, discontinued 25 years ago. PFT: moderate obstruction to airflow; DLCO 65% predicted. Chest CT: 3.1 cm spiculated, solid right lower lobe mass without any other parenchymal findings and no mediastinal/hilar adenopathy; PET-CT: +FDG uptake in RLL mass (SUV 5.1) without any other sites of uptake; EBUS: RLL mass--poorly differentiated adenocarcinoma, TTF+, EGFR/ALK -, PDL1-; stations R11, 7, R4, R2 nodes sampled with abundant lymphocytes, no tumor. Brain MRI: solitary, enhancing 10 mm lesion in the right parietal lobe with surrounding edema, suggestive of metastasis. Brain biopsy: adenocarcinoma, TTF+. What is the correct clinical stage for this patient?
T2aN0M1a, Stage IV
T2aN0M1b, Stage IV
T2aN0M1c, Stage IV
Najib Rahman, DPhil MSc
Lecture Title: What Have We Learned From Recent RCTs in Pleural Disease?
Randomised trials in pleural infection have demonstrated that (choose all that apply):
70% of patients will improve with a chest tube and antibiotics alone
Intrapleural DNase should be used after failed intrapleural fibrinolytic therapy
tPA + DNase is associated with reduced mortality compared to placebo
tPA + DNase is associated with reduced hospital stay compared to placebo
Randomised trials in malignant pleural effusion have demonstrated that (choose all that apply):
IPCs are superior to talc pleurodesis for symptoms
IPCs are associated with higher complications than pleurodesis
Small bore chest tubes are equally effective to large bore chest tubes for pleurodesis
Non-steroidals should be avoided in pleurodesis.
Speaker: Thomas Bleck, MD
Lecture Title: ICU Management of Subarachnoid Hemorrhage
The onset of clinical vasospasm is most closely associated with:
decreased interaction on the part of the patient
an increase in middle cerebral artery transcranial Doppler blood flow velocity
a shift toward lower frequency power in continuous EEG monitoring
development of a low grade fever
a gradual increase in mean arterial pressure
The most important factor in the diagnosis of cerebral salt wasting is:
the degree of decline in the serum osmolality
the degree of decline in the serum sodium concentration
the degree of increase in urine osmolality
the degree of increase in urine sodium
the extent of negative fluid balance
Speaker: Paul Palevsky, MD
Lecture Title: Renal Replacement Therapy for AKI in the ICU: When & How?
A 57-year-old man develops oliguric acute kidney injury in the setting of septic shock from pneumonia. He is intubated, sedated and mechanically ventilated. He is initially dependent upon vasopressor support with norepinephrine and vasopressin to maintain a mean arterial pressure >60 mmHg but has now been weaned off of vasopressin and has a blood pressure of 100/50 mm Hg on 0.02 mcg/kg/min of norepinephrine. His intake and output is positive by approximately 7.5 liters since admission. Renal replacement therapy is to be initiated because of worsening azotemia, mild hyperkalemia and moderate metabolic aciodosis.Which modality of renal replacement therapy would be most likely to to allow him to be discharged from the hospital independent of chronic dialysis dependence?
Conventional intermittent hemodialysis (IHD)
Continuous venovenous hemofiltration (CVVH)
Continuous venovenous hemodialysis (CVVHD)
Prolonged intermittent renal replacement therapy (PIRRT)
There is no difference between modalities with regard to mortality and renal recovery
Speaker: Steven Hollenberg, MD
Lecture Title: Technology to Predict Volume Responsiveness in the ICU: Any Clear Winners?
The goal of technologies that predict volume responsiveness is to predict that which of the following will increase after fluid administration?
Right heart filling pressure
Left heart filling pressure
Speaker: Nahid Bhadelia, MD, MA
Lecture Title: Improving critical care outcomes for filovirus patients in resource limited settings: Lessons from 2014 Ebola Epidemic and Beyond
What are the patient specific risk factors associated with high mortality in Ebola Virus Disease?
age (below 5 or above 40)
1 and 3
all of the above
Speaker: Alan Morris, MD
Lecture Title: Extracorporeal Life Support for Hypoxic Respiratory Failure: Medical Decision-making and Replicable Method Challenges
Correctly linking clinical decisions to guidelines/evidence 99% of the time in a critical care unit was reported to assure good patient protection from harmful clinician error.
Extracorporeal support for severe ARDS patients
should be widely employed because it is based on credible evidence
has enthusiastic supporters who have seen it salvage patients
requires more credible evidence with studies employing more standardization, before being widely employed in practice
Speaker: Andrew Haas, MD, PhD
Lecture Title: Bronchoscopic Cryobiopsy for ILD: Why Not “Just Do It?”
Complications from cryobiopsy for diffuse parenchymal lung disease have been:
consistently higher than routine transbronchial biopsy
consistently lower than routine transbronchial biopsy
highly variable across reported studies
the same as transbronchial biopsy
Speaker: Roy Brower, MD
Lecture Title: Setting Tidal Volume and PEEP in ARDS
Which of the following statements is true about tidal volumes and plateau pressures in ARDS patients?
Tidal volumes of 6 ml/kg predicted body weight should be used in all ARDS patients.
We should decrease tidal volume below 6 ml/kg only if the inspiratory plateau pressure exceeds 30-35 cm H2O.
There is no evidence that a tidal volume of 6 ml/kg is better than 8 or 9 ml/kg predicted body weight
In thin patients without abdominal distention, plateau pressures of 30-35 cm H2O may be safe.
In obese patients and in patients with abdominal distention, plateau pressures of 30-35 may be safe.
Which of the following statements is true about setting PEEP in ARDS patients?
There is abundant clinical evidence favoring the use of PEEPs that are substantially higher than those used in usual care practices.
A PEEP of 10 may have greater recruiting effects in a skinny patient than in an obese patient.
The "open lung approach" has many beneficial effects and very few detrimental effects.
Some ARDS patients respond to PEEP by recruiting lung and other ARDS patients do not respond by recruiting lung.
High PEEP has predominantly favorable hemodynamic effects.
Speaker: Frank Detterbeck, MD
Lecture Title: Advances in the Management of Early Stage Lung Cancer
Which of the following statements is false?
VATS (video-assisted thoracic surgery) resection is associated with better short term outcomes than thoracotomy.
SBRT (stereotactic body radiotherapy) in good risk patients is associated with somewhat worse long-term outcomes than surgical resection.
Minimally invasive adenocarcinoma represents an invasive lung cancer which requires prompt aggressive treatment.
Speaker: Suhail Raoof, MD
Lecture Title: A Rational HRCT Approach to Cystic Lung Diseases
All the following are true of incidental cysts except:
Uniformly distributed in all lobes of the lungs
Found more commonly in smokers
Seen usually in patients older than 55 years
Average size is 10 mm
Lymphocytic interstitial pneumonia on HRCT scan may demonstrate all the following except:
Cysts in up to 70% cases
May demonstrate basilar and perivascular predominance
May be associated with centrilobular ground glass nodules and ground glass opacities
Commonly demonstrates bizarre shaped, irregular, thick walled cysts in upper lobes
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