Use the following patient vignette to answer questions 1-3. 1.   Mr. Cheeseman is a 55-year-old man. He has been a pack-a-day smoker since the age of 20. He undergoes a pulmonary function test. Which of the following changes are most consistent with his diagnosis of Emphysema? FEV1 FEV1/FVC A. Low High B. Low Low C. High High D. High Low

Use the following patient vignette to answer questions 25 – 26. A 52-year old man arrives at your office complaining of dyspnea at rest and a non-productive cough. He states his cough has gotten worse over the past few months. He has been smoking 1 pack a day for the past 35 years and states he only has an occasional glass of wine at dinner. His family history is significant for pancreatic cancer. He complains that he has had trouble sleeping, has been very tired all the time, and has abnormal muscle cramping. Upon physical examination, you observe mild digital clubbing. You order a CT and find extensive honeycombing present at both lung bases. Which of the following is the most likely diagnosis for this patient?

Use the following patient vignette to answer questions 7 – 8. A 65-year-old woman is evaluated for a week-long fever, productive cough with purulent sputum, and increasing dyspnea. She smokes one pack of cigarettes a day. Her medical history includes hypertension and hypercholesterolemia, for which she is treated with simvastatin, hydrochlorothiazide, and aspirin. On physical examination, the patient is in mild respiratory distress. Temperature is 38.5°C (101.3°F), blood pressure is 145/85 mm Hg, pulse rate is 92/min, and respiration rate is 21/min; BMI is 28. Oxygen saturation is 92% with the patient breathing ambient air and 95% on oxygen, 2 L/min by nasal cannula. Pulmonary auscultation reveals bilateral expiratory wheezes and rhonchi. Physical exam reveals no digital clubbing but 1+ ankle edema. Lips are slightly bluish.  Chest radiograph shows increased bronchovascular markings. Laboratory values indicate normal CBC, except for an increase in neutrophils and hemoglobin. Arterial blood gases, while the patient was breathing ambient air, are pH 7.40, PCO2 41 mm Hg, and PO2 53 mm Hg. Spirometry shows an FEV1 of 45% of predicted and an FEV1/FVC ratio of 52%. 8. What is the best management plan for this patient?

For this declaration of a map variable, what does the string data type represent? map someMap;

Use the following patient vignette to answer questions 11 – 13. A 35-year-old man presents with a sputum-producing cough and dyspnea at rest. Past medical history is significant for a previous diagnosis of premature emphysema at age 28. The patient denies smoking and excessive alcohol intake or exposure to dust and mold. Family history is significant for coronary artery disease and pulmonary disease in the patient’s father and only brother. Vital signs are within normal limits except for blood pressure of 160/120 mmHg on three readings.  Physical examination reveals an ill-appearing man with prolonged expiratory time. Auscultation of the lungs reveals end-expiratory wheezing. ECG is within normal limits. Which of the following is the most likely risk factor/predisposing condition for this patient’s illness?

Use the following patient vignette to answer questions 28 – 29. Maya, a 33 y.o. African American woman, presents to the ED with dry cough and dyspnea. She is not a smoker and denies having asthma. She is very concerned about her cough because she works 60 hours per week in a prestigious law firm. You notice some minor cuts on her hands and inquire about them. Frustrated, she responds that they are mostly from handling many case files, but they haven’t healed properly for the past two weeks, despite using Neosporin (topical ointment) daily. PFTs show low TLC and reduced DLco. Chest X-ray reveals bilateral hilar adenopathy, with no infiltrates. You ordered blood work before your imaging. What abnormal lab result(s) do you expect?

For this declaration of a map variable, what does the string data type represent? map someMap;

Use the following patient vignette to answer questions 7 – 8. A 65-year-old woman is evaluated for a week-long fever, productive cough with purulent sputum, and increasing dyspnea. She smokes one pack of cigarettes a day. Her medical history includes hypertension and hypercholesterolemia, for which she is treated with simvastatin, hydrochlorothiazide, and aspirin. On physical examination, the patient is in mild respiratory distress. Temperature is 38.5°C (101.3°F), blood pressure is 145/85 mm Hg, pulse rate is 92/min, and respiration rate is 21/min; BMI is 28. Oxygen saturation is 92% with the patient breathing ambient air and 95% on oxygen, 2 L/min by nasal cannula. Pulmonary auscultation reveals bilateral expiratory wheezes and rhonchi. Physical exam reveals no digital clubbing but 1+ ankle edema. Lips are slightly bluish.  Chest radiograph shows increased bronchovascular markings. Laboratory values indicate normal CBC, except for an increase in neutrophils and hemoglobin. Arterial blood gases, while the patient was breathing ambient air, are pH 7.40, PCO2 41 mm Hg, and PO2 53 mm Hg. Spirometry shows an FEV1 of 45% of predicted and an FEV1/FVC ratio of 52%. 8. What is the best management plan for this patient?

BONUS QUESTION 41. If the acute respiratory distress condition persists in the patient in question 40, how would you manage the patient then?

What function of the map (and other containers) gives us an iterator to the first element of that container?