ASTHMA COPD

Question 1

asthma: preferred ics laba track
step 1-2

Answer 1

step 1-2: as needed low dose ics-formoterol

Question 2

asthma: preferred ics laba track
step 3

Answer 2

step 3: low dose ics formoterol maintenance
1 inhalation BD and 1 prn

Question 3

asthma: preferred ics laba track
step 4

Answer 3

step 4: medium dose maintenance
2 inhalation BD and 1 prn

Question 4

asthma: alternative track
step 1

Answer 4

step 1: take ics whenever SABA is taken

Question 5

asthma: alternative track
step 2

Answer 5

step 2: low dose maintenance ICS (eg budesonide)

Question 6

asthma: alternative track
step 3

Answer 6

step 3: low dose maintenance ics-laba

Question 7

asthma: alternative track SABA
step 4

Answer 7

step 4: medium/high-dose maintenance ics-laba

Question 8

asthma: preferred ics laba track
step 5

Answer 8

step 5: add on LAMA

Question 9

what is the reliever for asthma preferred track

Answer 9

as needed low-dose ics formoterol

Question 10

asthma: alternative track SABA
step 1
step 2
step 3
step 4
step 5

Answer 10

step 1: take ics whenever SABA is taken
step 2: low dose maintenance ICS
step 3: low dose maintenance ics-laba
step 4: medium/high-dose maintenance ics-laba
step 5: add on lama

Question 11

what is the reliever for asthma alternative track

Answer 11

ics-saba or saba

Question 12

when to prescribe abx for asthma. what kind of abx

Answer 12

strong presence of lung infection (eg. fever and purulent sputum or evidence of pneumonia).

augmentin + macrolide

Question 13

how does magnesium sulfate help in asthma exacerbation

Answer 13

brochodilator, blocks ca ion influx into smooth muscles

Question 14

IL5 biologics for asthma (name 3)

Answer 14

mepolizumab, reslizumab, benralizumab

Question 15

what does dupilumab target in asthma

Answer 15

il 4 alpha receptor

Question 16

anti igE antibody for asthma (name 1)

Answer 16

omalizumab

Question 17

side effects of beta agonist inhalers (list 5)

Answer 17

Tremor, headache, tachycardia, palpitations, hypokalemia

Question 18

if patient has daily symptoms of asthma and is waking at night at least once a week, what to start patient on

Answer 18

medium dose ics formoterol SMART

Question 19

if patient has symptoms almost every day OR wakes up at night at least once a week, what to start to patient on

Answer 19

low dose ics formoterol smart

Question 20

if patient has symptoms less than 3-5 days a week with normal lung function

Answer 20

as needed low dose ics formoterol

Question 21

for pts in group A COPD, what is the mmrc and cat score

Answer 21

mmrc 0-1
cat <10

Question 22

for pts in group B COPD, what is the mmrc and cat score

Answer 22

mmrc ≥ 2
cat score ≥ 10

Question 23

what qualifies a patient to be in group E COPD

Answer 23

at least 2 moderate exacerbations
OR 1 leading to hospitalisation

Question 24

choice of therapy for group A COPD patients

Answer 24

any bronchodilator

Question 25

choice of therapy for group B COPD

Answer 25

LABA + LAMA (umeclid, tiotrop, glycopy)

Question 26

choice of thp for group E COPD

Answer 26

LABA + LAMA, add on ICS if eosinophil more than 300

Question 27

how does theophylline work

Answer 27

Non-selective phosphodiesterase inhibitors

Question 28

dose related side effect of theophylline

Answer 28

arrhythmias, seizures

Question 29

choice of antibiotic therapy in patients with COPD (list 2)

Answer 29

1. Azithromycin 250mg OD or 500mg 3x/week
2. Erythromycin 250mg BD

benefit only shown for 1 year of treatment

Question 30

usage of azithromycin is preferred in?

Answer 30

former smokers

Question 31

usage of roflumilast is preferred in?

Answer 31

fev1 <50% and chronic bronchitis

Question 32

when to initiate pulmonary rehab

Answer 32

group B, E COPD

Question 33

list 5 vaccinations in copd

Answer 33

1. flu
2. covid 19
3. pneumococcal (PCV13 followed by ppsv 23)
4. Tdap if not vax in adolescence
5. Zoster vaccine in people with COPD over 50y