2024 NYS Thoracic Society Pre-Test Questionnaire

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

Matthew Moll, MD, MPH

Advances in COPD Precision Medicine

The heritability of COPD is estimated to be:

1 point

10%

20%

40%

60%

80%

With respect to dupilumab and COPD therapy, eosinophil counts are an example of:

1 point

A genetic predictor (e.g., polygenic risk score)

A monogenic risk factor

An endotype

An environmental exposure

A blood-based biomarker

Carolyn D'Ambrosio, MD, MS

Sex and Gender Influences in Sleep Disorders

Which of the following is true regarding pregnancy and OSA?

1 point

Most pregnant patients snore

OSA in pregnancy is worse in the first trimester

OSA In pregnancy is commonly identified and treated

OSA In pregnancy has a higher prevalence in the third trimester

Women are more likely than men to present with the all of the following symptoms of OSA except:

1 point

Witnessed apneas

Fatigue

Depression

Insomnia

Rany Condos, MD

Radiology for the ILD Clinician

A radiographic typical UIP and probable UIP pattern are distinguished by presence of honeycombing.
*

1 point

Yes

ILA’s (Interstitial lung abnormalities) can include ground glass abnormalities and must affect at least 5% of the lung.
*

1 point

Yes

Augusto Litonjua, MD, MPH

Trudeau Lecture: Early Life Origins of Asthma & Lung Disease

Which of the following statements about the Developmental Origins of Health and Disease is/are correct?

1 point

Adverse prenatal exposures affecting lung development all lead to low birthweight in neonates.

Exposures in early life that lead to later disease act through mechanisms of programming during development.

Mechanisms in early life that represent physiological processes of developmental plasticity given specific environmental situations (e.g. decreased nutrients) may have potential adverse consequences later in life, when there is a change in the environment (e.g. plentiful nutrients).

All of the above

None of the above

Determinants of adult lung function include peak attained lung function, length of the plateau phase, and rate of decline of lung function.

1 point

True

False

Akhilesh Sista, MD, FSIR, FAHA

Endovascular Therapy for Acute PE – Embracing the Era of Rigorous Clinical Trial Data

Which of the following is one of the primary outcomes of the PE-TRACT trial?

1 point

6-minute walk distance

Generic quality of life

Disease-specific quality of life

Peak oxygen uptake (VO2 max)

Clinical Deterioration

Stephen Graziano, MD

Clinical and Molecular Prognostic Factors in Lung Cancer

The following clinical/molecular factors are predictive, except one: *

1 point

EGFR mutation status

ALK Rearrangement

PD=L1 expression

Performance status

K-nas G126 mutation status

Jeremy Beitler, MD, MPH

Updates in ARDS Phenotyping and Management

Which of the following statements regarding plateau pressure is true:

1 point

Plateau pressure of 30 cm H2O indicates the lung is distended to physiologic total lung capacity

Plateau pressure is strongly correlated with mortality independent of driving pressure.

Plateau pressure exhibits a threshold effect at 30 cm H2O, below which mortality is constant.

Plateau pressure can exceed peak inspiratory pressure, even in pressure-control ventilation.

Plateau pressure of 30 cm H2O should never be exceeded, even in patients with morbid obesity.

Molecular sub phenotyping of ARDS:

1 point

Has consistently identified 2 classes of patients distinguished largely by degree of inflammation

Can distinguish treatment-responsive patients using a single cytokine biomarker

Has been prospectively implemented in clinical trials

Identifies patients likely to benefit from neuromuscular blockade

Has not been replicated outside of ARDSNet studies

Jeremy Richards, MD, MA, FACP, ATSF
Paritosh Prasad, MD, MBA

Pro/Con- Steroids in Community Acquired Pneumonia

In which of the following patients with Community Acquired Pneumonia should steroids not generally be used?

1 point

A 65yo M with community acquired pneumonia and COPD flare

A 38yo F with severe community acquired pneumonia requiring hospitalization

A 58yo F with community acquired pneumonia and concurrent influenza infection

A 31yo M with community acquired pneumonia and asthma exacerbation

Steroids will provide benefit in all of the above patients

A 65yo man with hypertension, hyperlipidemia, type 2 diabetes, and benign prostatic cancer is admitted to the ICU with community acquired pneumonia. He was intubated and initiated on mechanical ventilation in the Emergency Department, and was initiated on norepinephrine 0.07mcg/kg/min for hemodynamic support after intubation. He has been initiated on vancomycin, ceftriaxone, and azithromycin for empiric treatment. Would it be appropriate to provide glucocorticoids to this patient for adjuvant treatment of community acquired pneumonia?

1 point

Yes – it would be appropriate to provide hydrocortisone 200mg IV via continuous infusion

Yes – it would be appropriate to provide methylprednisolone 125mg q6h IV

No – glucocorticoids are contraindicated due to his severity of illness

No – glucocorticoids are contraindicated due to his diagnosis of type 2 diabetes

Unable to determine – more information is needed to make a decision about glucocorticoids

Morgan Soffler, MD

Goldilocks and the 3 PEEPs: Physiologic Ventilator Titration

Which of the following is a correct statement about PEEP titration?

1 point

A high PEEP strategy is indicated for patients with severe ARDS.

The best PEEP by best tidal compliance is the PEEP with the lowest driving pressure.

Recruitment maneuvers with brief application of high PEEP are safe rescue maneuvers for all-comers with ARDS.

Driving pressure is the difference between the peak and the plateau pressure.

Titrating PEEP to best driving pressure is the best PEEP titration method.

Raj Parikh, MD, MPH

Pulmonary Vasodilators and PH-ILD: How to Treat

What is the optimal dose for inhaled treprostinil to effectively treat PH-ILD based on the INCREASE study?

1 point

1 Breath qid

3 Breaths qid

6 Breaths qid

9 Breaths qid

Based on the INCREASE study, what parameters may NOT improve in PH-ILD patients treated with inhaled treprostinil?

1 point

6 minute walk distance

ProBNP levels

Need for cardiopulmonary hospitalization

Mortality

Cynthia Taub, MD, MBA

Echocardiography in the ICU

The patient developed worsening dyspnea after being admitted to the ICU for possible pneumonia. She received 1 liter of IV fluid and antibiotics. A stat echo was performed as shown. What is the diagnosis and the next step?

1 point

Infective endocarditis. Recommend ID consult

Volume overload. Recommend dieresis.

Flail mitral valve. Recommend CT surgery consultation

ARDS. Recommend CT of chest and prepare for ECMO.

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