Asthma and COPD Quiz Flashcards
- Which of the following are short acting beta agonists (check all)
A. Salbutamol
B. Terbutaline
C. Formoterol
D. Salmeterol
A, B
Which of the following statements correctly differentiates between asthma and COPD (check those that apply);
A. Breathlessness is variable in COPD but more progressive and persistent in asthma
B. Symptoms in COPD are intermittent and variable, whereas in asthma they are progressive and worsening
C. Chronic productive cough is rare in COPD and common in asthma
D. Allergies frequently occur with COPD and infrequently in asthma
E. The pathophysiology involved in asthma is primarily eosinophilic, where in COPD it is neutrophilic
E.
A patient complains of dry mouth after using his inhaler, which drug would be most likely responsible for this adverse effect?
A. salbutamol
B. fluticasone
C. vilanterol
D. ipratropium
D.
Which of the following patients should be screened for asthma or COPD with a spirometry test?
A. A 28 year old smoker with an 8 pack year history of smoking, with a chronic cough
B. A 12 year old boy with chronic urticaria and eczema
C. A 70 year old ex-smoker (quit 5 years ago) with a 20 pack year history of smoking, but has no complaints
D. A 42 year old ex-smoker (quit 2 years ago) with a 10 pack year history of smoking and has a chronic cough with sputum production
E. A 34 year old male with a sedentary lifestyle who is frequently short on breath with strenuous activity
D.
What is the post-bronchodilator FEV1/FVC ratio on spirometry that is used to confirm a diagnosis of COPD?
A. 0.5
B. 0.6
C. 0.7
D. 0.8
C.
A patient with COPD has an FEV1 is 57%. She walks slower than most people of the same age. She does not have a history of acute exacerbations (AECOPD) within the past year.
Her stage of COPD would be considered:
A. Mild
B. Moderate
C. Severe
D. Very severe
B.
A patient picks up their prescription for Advair (salmeterol/fluticasone) Diskus. Which is the appropriate way to use the device?
A. Prepare the dose. Place lips around the mouthpiece. Exhale into the device. Inhale steadily and deeply. Hold breath for 10 seconds, and breathe out slowly.
B. Shake the device. Prepare the dose. Place lips around mouthpiece. Breathe in steadily and deeply. Hold breath for 10, and breathe out slowly.
C. Shake the device. Prepare the dose. Place lips around mouthpiece. Exhale into the device. Inhale steadily and deeply. Hold breath for 10 seconds, and breathe out slowly.
D. Prepare the dose. Breathe out away from the device. Place lips around mouthpiece. Inhale forcefully and deeply. Hold breath for 10 seconds, and breathe out slowly.
D.
Which of the following long acting beta agonists is NOT indicated in asthma? (Check those that apply)
A. formoterol
B. salmeterol
C. vilanterol
D. olodaterol
D.
A patient with COPD is considered to be at ‘high risk’ of exacerbation if they had:
A. At least 1 moderate or severe exacerbation in the last year requiring a hospital admission or ED visit
B. At least 2 moderate or severe exacerbations in the last year requiring a hospital admission or ED visit
C. At least 2 moderate or at least 1 severe exacerbations in the last year requiring a hospital admission or ED visit
D. At least 3 moderate or at least 1 severe exacerbations in the last year requiring a hospital admission or ED visit
C.
Which bronchodilator has the longest duration of action?
A. Aclindinium
B. Salmeterol
C. Formoterol
D. Ipratropium
E. Umeclidinium
E.
Which of the following statements is TRUE about delivery devices (check all that apply)
A. The newer dry powdered inhalers (Ellipta® and Genuair®) have been shown to be more effective than the older dry powdered inhalers at maintaining asthma control and decreasing mortality
B. The new soft mist inhaler (Respimat®) has evidence to show that it is more effective than the MDI at decreasing morbidity associated with asthma
C. If used correctly, a metered dose inhaler with a spacer is just as effective as using a nebulizer
D. Approximately 20% percent of patients will have errors in their inhaler technique, which is why counseling is so important
C.
A 20-year old male with asthma is taking fluticasone 250mg MDI 1 puff od. He also uses a salbutamol MDI 1-2 puffs q4-6 hours prn. He is using salbutamol ~ 5 times per week.
Which is the best option?
A. continue monitoring, no change required
B. suggest changing the ICS to another ICS
C. discontinue the ICS and try a LABA instead
D. add a LABA to the ICS
D.
The CAT test is:
A. used for monitoring asthma symptoms
B. used to stage the severity of asthma
C. used to measure the impact of COPD on a person’s life
D. used to stage the severity of COPD
C.
A 6 year old boy with severe asthma is having an asthma flare, and he is now being given a prescription for oral prednisolone (5mg/5ml): take 15mls once daily x 7 days. What would be important to talk about with his parents at this time?
A. Every other day dosing of his corticosteroids may be beneficial to diminish any chances of HPA Axis suppression
B. He may experience an upset stomach (nausea, vomiting) and may be more irritable for the next week
C. He will have to stop taking the inhaled steroid while on the oral prednisolone to minimize the chances of growth suppression
D. There is likely to be some growth suppression with the prednisolone, however he will ‘catch up’ after discontinuing it
B.
Which of the following is not a biologic used in the treatment of severe asthma?
A. mepolizumab
B. omalizumab
C. venralizumab
D. benralizumab
C.
The usual initial first choice of therapy for a patient with stable COPD whose mMRC is 1 and has a low risk of future exacerbations is?
A. LAMA
B. SAMA
C. ICS
D. ICS/LABA
A.
Which of the following statements are FALSE about spirometry:
A. It is necessary for diagnosing COPD
B. It is used for pre-employment screening or surveillance for occupational lung disease
C. It is a method of assessing lung function by measuring the volume of air a patient can expel, after maximum inspiration
D. It is useful for day to day self-monitoring of symptoms
E. Results can be compared to a patient’s predicted normal, or a patient’s personal best
D.
Which is the starting treatment for a person with COPD at high risk of future exacerbations
A. LAMA or LABA
B. LAMA/LABA
C. LAMA/ICS
D. LAMA/LABA/ICS
D.
An 18 year old woman has an acute asthma flare following a 3-day history of upper respiratory track symptoms (clear nasal discharge, dry cough, no fever). She is using ciclesonide daily and salbutamol prn as directed and continues to have difficulty with coughing and wheezing. Her PEF is 52% of her personal best. Which medication should most likely be added?
A. montelukast
B. salmeterol
C. prednisone
D. tiotropium
C.
A patient is experiencing an acute exacerbation and is hospitalized and treated with salbutamol and ipratropium and an oral corticosteroid. Which of the following will likely be monitored: (Choose all that apply)
A. Blood glucose
B. O2 saturation
C. Potassium
D. Spirometry
D.
All of the following statements about Action plans are true EXCEPT:
A. Action plans use the traffic light system to help a patient gauge their symptoms
B. Action plans should include daily preventative management strategies, such as when to adjust doses of medication
C. All patients with asthma should receive an action plan
D. Action plans should be generic. A printout is available on the Lung Association website to handout at the pharmacy.
D.
The single biggest risk factor for COPD is:
A. a history of childhood respiratory infections
B. a history of smoking
C. a history of asthma
D. exposure to occupational chemicals
B.
Which device would you likely want to avoid in someone with arthritis and poor dexterity?
A. genuair
B. turbuhaler
C. diskus
D. breezhaler
D.
After initiating an inhaled corticosteroid for asthma, improvement in symptoms would be expected to start to occur
A. on the first day of use
B. within 2-14 days
C. in about 3-4 weeks
D. in about 1-2 months
B.
Regarding the use of long acting beta2 agonists (LABAs) in asthma and COPD which of the following is TRUE?
A. LABAs should never be used as monotherapy in asthma
B. LABAs should never be used as monotherapy in COPD
C. LABAs should never be used as monotherapy in both asthma and COPD
D. LABAs should never be used in children less than 12
A.
Which of the following systemic corticosteroid doses is the most potent?
A. methylprednisolone 8mg
B. triamcinolone 10mg
C. prednisone 15mg
D. hydrocortisone 18mg
C.
Which of the following drugs is not used in the treatment of COPD?
A. roflumilast
B. azithromycin
C. N-acetylcysteine
D. omalizumab
D.
What kind of device is Salmeterol (Serevent)
Discus
What kind of device is tiotropium (Spriva)
Respimat
What kind of device is ipratropium (Atrovent)?
MDI
What kind of device is Terbutaline (Bricanyl)?
Turbuhaler
Which of the following devices are considered dry powdered inhalers? (check all that apply)
A. Ellipta
B. Genuair
C. MDI
D. Respimat
E. Turbuhaler
A, B, E.
Which of the following is true about antibiotic use in acute exacerbations of COPD?
A. Most triggers are infectious in nature, they should be prescribed to all patient
B. They should only be used after the results of a sputum sample are available
C. They should be used empirically in all patients experiencing a change in sputum colour (to yellow or green)
D. They should be used in all patients requiring mechanical ventilation
D.
