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ChapterSurgery Cardiothoracic Surgery

Empyema and pleural space infections

Free notes, MCQs, tables & flowcharts for USMLE Step 3 Surgery

10Questions
7Flashcards
2Tables & Flowcharts

Sample Questions

1

Myeloperoxidase (MPO) is a heme-containing molecule that is found in the azurophilic granules of neutrophils. Upon release, the enzyme catalyzes hypochlorous acid production during the phagocytic response. In the setting of pneumonia, which of the following clinical findings is most directly associated with myeloperoxidase activity?

AShortness of breath

BGreen color of sputum

CRust-tinged sputum

DCough

EFever

2

A previously healthy 21-year-old man is brought to the emergency department 4 hours after the sudden onset of shortness of breath and pleuritic chest pain. He has smoked 1 pack of cigarettes daily for the past 3 years. He is 188 cm (6.2 ft) tall and weighs 70 kg (154 lb); BMI is 19.8 kg/m2. Physical examination shows decreased tactile fremitus and diminished breath sounds over the left lung. Which of the following is the most likely cause of this patient's symptoms?

AEmbolic occlusion of the pulmonary artery

BInflammation of the costal cartilage

CRupture of a subpleural bleb

DInfection with gram-positive diplococci

EHyperresponsiveness of the bronchial system

3

An x-ray of the chest is conducted and shown below. Which of the following is the most appropriate next step in management?

AAdminister isoniazid for 9 months

BRepeat PPD skin test

CObtain a chest CT scan

DPerform interferon-γ release assay

EAdminister isoniazid + rifampin + pyrazinamide + ethambutol

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