asthma, COPD

Question 1

Cough < 2 x/wk or < 2 x/month at noc =
Cough > 2 x/week or > 2x/month at noc =
Cough daily or > 1x/wk at noc=
Continuous cough and frequently at noc=

Answer 1

intermittent
mild
moderate
severe/persistent

Question 2

For mild-persistent asthma:

Answer 2

ICS

Question 3

Duoneb is a combo of:

Answer 3

ipratropium and a SABA

Question 4

You always want to rank at the ___ level where one falls under a category

Answer 4

highest

Question 5

Green zone =
Yellow zone =
Red zone =

Answer 5

maintain on ICS and LABA
ICS and SABA
All of the above and add on oral steroid (prednisone)

Question 6

A LABA should never be used ___ and is not meant as a ___ inhaler. Routine use is ___.

Answer 6

alone, rescue, discouraged

Question 7

Pt’s who are pregnant and have asthma can only get the ___ influenza vaccine.

Answer 7

killed

Question 8

Bronchitis is ___ in nature, so don’t treat w/an ___

Answer 8

viral, antibiotic

Question 9

Hoarseness in a voice is a dead giveaway indicating it is ___

Answer 9

viral

Question 10

Leukotrienes are chemicals the body releases when you breathe in an allergen (pollen). They cause ___ in the lungs and tightening of the ___ , which can result in asthma symptoms such as wheezing

Answer 10

swelling, airways

Question 11

What b/p medication category would you want to avoid w/asthma and COPD d/t causing bronchoconstriction?

Answer 11

beta-blockers

Question 12

A chronic disease process that results in airway inflammation that produces airway obstruction that is reversible either spontaneously or w/bronchodilators.

Answer 12

asthma

Question 13

A chronic disease d/t progressive/ongoing inflammatory changes secondary to noxious particles or gases which results in airflow obstruction that is NOT fully reversible.

Answer 13

COPD

Question 14

wheezing, chest tightness, and cough fall under ___.

Answer 14

asthma

Question 15

sputum production, cough, dyspnea, airflow limitation, and impaired gas exchange fall under ___.

Answer 15

COPD

Question 16

COPD may include 1 or all of the following: ___, ___, ___.

Answer 16

chronic bronchitis, emphysema, asthma

Question 17

Difficulty getting air out occurs in ___ lung disease and you have ___ FEV. Decreased lung volume bc you can’t get enough air in, occurs in ___ lung disease and you have ___ FEV.

Answer 17

obstructive, low, restrictive, normal

Question 18

Strong family hx, reversible, occurs in childhood, and airway irritants fall under: ___.

Answer 18

asthma

Question 19

occurs in older adult, non-reversible, cigarette smoking, and progressive over lifetime fall under ___.

Answer 19

COPD

Question 20

DOC for both asthma and COPD, as well as EIB is: ___, like ___.

Answer 20

Short-acting beta-agonist (SABA), albuterol

Question 21

Use ___ ___, like ___ for exacerbations of asthma and COPD as quick-relief med.

Answer 21

oral steroids, predinose

Question 22

As the disease progresses, may need to start on ___.

Answer 22

long-acting beta-agonist (LABA)

Question 23

___ is the #1 chronic disease in children.

Answer 23

asthma

Question 24

___ is the primary cause of COPD.

Answer 24

smoking

Question 25

What are the common 4 things that cause cough?

Answer 25

asthma, obesity, GERD, post-nasal drainage

Question 26

What are the 4 arms of treatment therapy for asthma?

Answer 26

objective measurement, environmental control, pharmacology, pt education

Question 27

Perform an exercise challenge test when testing for ___. > 15% in peak flow will indicate this.

Answer 27

exercise-induced bronchospasm (EIB)

Question 28

short-term control is the same for every step and is a ___, like ___.

Answer 28

SABA, albuterol

Question 29

``` Step 1 (intermittent): Step 2 (mild persistent): Step 3 (moderate persistent): Step 4 (moderate persistent): Step 5 (severe persistent): Step 6 (severe persistent); ```

Answer 29

``` SABA Low-dose ICS Low-dose ICS + LABA Medium-dose ICS + LABA High-dose ICS + LABA High-dose ICS + LABA + oral steroid ```

Question 30

Exposures to avoid w/asthma:

Answer 30

allergens, tobacco smoke, high air pollution, ASA and NSAIDS (can precipitate asthma attack)

Question 31

Do not use ___ or ___ when a pt has asthma d/t precipitating an asthma attack.

Answer 31

ASA, NSAIDS

Question 32

Sympathetic nervous system includes the neurotransmitter ___ and ___ things up. Parasympathetic nervous system includes the neurotransmitter ___ and ___ things down.

Answer 32

norepinephrine, speeds, acetylcholine, slows

Question 33

SABA's include: ___. They have a ___ onset w/in 1-5 mins.

Answer 33

albuterol (proventil.ventolin), terbutaline (brethaire), levalbuterol (xoponex), rapid

Question 34

Beta-agonists have ___ effects and ___ HR and contractility.

Answer 34

adrenergic, increase

Question 35

The major effect of beta 2 agonists is ___ ___ ___ ___.

Answer 35

bronchial smooth muscle relaxation

Question 36

___ is an ___ and is indicated as quick-relief for asthma secondary to the use of beta 2 agonists. Should not be used for ___.

Answer 36

Ipratropium, anticholinergic, EIB

Question 37

You get more delivery of the inhaler product with a ___.

Answer 37

spacer

Question 38

True or False: MDI's and VHC's are as effective as a nebulizer in both the nonacute and acute scenario of asthma.

Answer 38

True

Question 39

Ipratropium + albuterol = ___. This is given in ER for exacerbations.

Answer 39

combivent

Question 40

Steroids can cause an ___ of blood sugar and changes in ___.

Answer 40

elevation, behavior

Question 41

long-term control meds are used on a ___ basis to maintain control of asthma and are not indicated for ___.

Answer 41

daily, exacerbations

Question 42

___ are the most effective long-term therapy for pt's w/persistent asthma.

Answer 42

ICS's

Question 43

Directions after use of inhaler include: ___ mouth, brush teeth to prevent ___.

Answer 43

rinse, thrush

Question 44

ICS's have the potential to ___ growth in children. Check ___ every 3-4 months during first yr of therapy. Once steroids have been stopped, children typically will still achieve normal adult height.

Answer 44

stunt, height

Question 45

Long-term therapy includes:

Answer 45

inhaled/oral corticosteroids, cromolyn sodium, LABA's, LTRA's, immunomodulators

Question 46

Consider supplements of ___ and ___ w/use of ICS's.

Answer 46

calcium, vitamin D

Question 47

LABA's include: ___. | Comb LABA's include:

Answer 47

salmetrol (serevent), formoterol (foradil) | Advair, Symbicort

Question 48

LTRA's include: ___. They are a ___ option for mild persistent asthma.

Answer 48

montelukast (singulair), secondary

Question 49

The ___ pathway is the starting point for prostaglandins, thromboxanes, and leukotrienes

Answer 49

AA

Question 50

___ is a long-acting bronchodilator/methlxanthine. Must maintain ___ drug levels at a "steady state". Target serum level range is ___-___ mcg/ml. It is not used for ___ exaerbations.

Answer 50

Theophylline, serum, 5-20, acute

Question 51

DOC for acute episodes of asthma/EIB is ___. DOC for long-term asthma therapy is ___.

Answer 51

SABA (albuterol), ICS's

Question 52

Omalizumab (xolair) prevents binding of ___ to ___ cells and basophils, so it limits the release of histamine and leukotrienes. Used in steps ___ or ___.

Answer 52

IgE, mast, 5, 6

Question 53

Pt education for asthma pt's include:

Answer 53

written plan for daily management and management of acute exacerbations, asthma triggers

Question 54

Cyanosis, obese, hypoventilation, edema, high PCO2 (bc you can't blow it off) are all manifestations of ___ ___. Is an indication of chronic ___.

Answer 54

"blue bloaters", bronchitis

Question 55

Pink, thin, barrel chest, hyperventilation, pursed lips, low-normal PCO2 are manifestations of ___ ___. Is an indication of ___.

Answer 55

"pink puffer", emphysema

Question 56

Pulmonary rehab is important for the later stages of ___.

Answer 56

COPD

Question 57

Try all other tx's before starting COPD pt on ___.

Answer 57

O2