Chapter 25-Obstructive Lung Disease

Question 1

What is copd

Answer 1

A progressive obstructive lung disease characterized by persistent airflow limitation

Question 2

What is emphysema

Answer 2

Abnormal enlargement and destruction of airspaces beyond the terminal bronchiole

Question 3

What is chronic bronchitis

Answer 3

Chronic productive cough for at least 3 months per year of 2 consecutive years

Question 4

What are the two most common risk factors for copd

Answer 4

Cigarette smoking

Alpha-1-antitrypsin deficiency

Question 5

What treatment can be done for patients with copd and a-1-anti trypsin deficiency

Answer 5

I.v augmentation therapy

Question 6

Breath sounds with copd include

Answer 6

Wheezing or diminished breath sounds

Question 7

Symptoms of copd

Answer 7

Productive cough
Wheezing
Dyspnea on exertion

Question 8

What are late signs of copd

Answer 8

Diaphragm flattening
Hoover sign-chest wall drawn inward at level of diaphragm
Edema
Cor pulmonale

Question 9

When should aat deficiency be suspected

Answer 9

When copd presents in a non smoker
Someone under 50
Family history of liver or lung disease
Emphysema present more in lung bases

Question 10

Mild copd diagnosis is

Answer 10

Fev1/Fvc less than 70%

And fev1 greater than 80% predicted

Question 11

Moderate copd diagnosis is

Answer 11

Fev1/Fvc less than 70%

And fev1 50-80% predicted

Question 12

Severe copd is

Answer 12

Fev1/Fvc less than 70%

And fev1 30-50% predicted

Question 13

Very severe copd diagnosis is

Answer 13

Fev1/Fvc less than 70%

And fev1 less than 30% predicted

Question 14

What is asthma

Answer 14

Airway inflammation and obstruction that is reversible spontaneously or with treatment

Question 15

Symptoms of asthma

Answer 15

Wheezing
Dyspnea
Chest tightness
Cough

Question 16

How can a diagnosis of asthma be confirmed by pft

Answer 16

Fev1 or fvc improvement by at least 12% and 200 mls post bronchodilator

Question 17

The diagnosis of asthma can be excluded by which test

Answer 17

Methacholine test

Question 18

Peak flow measurement of 80-100 indicates

Answer 18

Green zone

Question 19

Peak flow measurement of 60-80 indicates

Answer 19

Yellow zone

Question 20

Peak flow measurement of less than 60 indicates

Answer 20

Red zone

Question 21

Red zone requires

Answer 21

Immediate medical attention

Question 22

What is bronchiectasis

Answer 22

Chronic production of purulent sputum

Question 23

What is the standard of diagnosis for bronchiectasis

Answer 23

Ct- diagnosed when the diameter of the bronchus exceeds the diameter of the adjacent pulmonary artery branch

Question 24

What are the three patterns of bronchiectasis

Answer 24

Cylindrical
Varicose
Cystic

Question 25

What is cylindrical bronchiectasis

Answer 25

Airway wall is uniformly dialated

Question 26

What is varicose bronchiectasis

Answer 26

Irregular pattern with areas of constriction and dilation

Question 27

What is cystic bronchiectasis

Answer 27

Progressive distal enlargement of the airways

Question 28

Mmrc of 1 and cat of 9 with no exasperation’s in the last year is

Answer 28

A

Question 29

Mmrc of 1 and cat of 9 with 2 exasperation’s in the last year is

Answer 29

C

Question 30

Mmrc of 2 and cat of 11 with 2 exasperation’s in the last year is

Answer 30

D

Question 31

Mmrc of 2 and cat of 11 with no exasperation’s in the last year is

Answer 31

B

Question 32

Mild copd treatment

Answer 32

Lama

Question 33

Moderate copd treatment

Answer 33

Lama/laba

Question 34

Severe copd treatment

Answer 34

Higher dose lama/laba

Question 35

Asthma copd overlap treatment

Answer 35

Ics/laba

Question 36

Panlobular emphysema is typically caused by

Answer 36

Genetics

Question 37

Panlobular emphysema is destruction of

Answer 37

All airspace’s

Question 38

Centrulobular emphysema is usually caused by

Answer 38

Smoking

Question 39

Centrilobular emphysema is destruction of

Answer 39

Central alveoli

Question 40

Signs and symptoms of emphysema

Answer 40

Barrel chest Dyspnea Polycythemia Nonproductive cough

Question 41

Signs of bronchiectasis

Answer 41

Chronic cough Recurrent infections Hemoptysis

Question 42

Asthma is increased

Answer 42

Airway resistance

Question 43

Copd is decreased

Answer 43

Lung compliance

Question 44

Extrinsic asthma is a result of

Answer 44

Antigen and antibody reactions on mast cells in resp tract

Question 45

Extrinsic asthma usually presents with

Answer 45

Food allergies Eczema Increased eosinophils

Question 46

Intrinsic asthma may be caused by

Answer 46

Autonomic nervous system dysfunction

Question 47

What drugs can trigger asthma attacks

Answer 47

Aspirin and beta blockers

Question 48

What are the 4 questions for asthma control

Answer 48

1-daytime symptoms more than 2x a week 2-reliever needed more than2x a week 3- any activity limitation 4-any night waking

Question 49

A score of 0 on the questions for asthma control indicates

Answer 49

Well controlled asthma

Question 50

A score of 1-2 on the questions for asthma control indicates

Answer 50

Partly controlled

Question 51

A score of 3-4 on the questions for asthma control indicates

Answer 51

Poor control

Question 52

Step 1 asthma treatment

Answer 52

Ics or formoterol prn

Question 53

Step 2 asthma treatment

Answer 53

Daily low dose formoterol or ics

Question 54

Step 3 asthma treatment

Answer 54

Low dose ics/laba

Question 55

Step 4 asthma treatment

Answer 55

Med dose ics/laba

Question 56

Step5 asthma treatment

Answer 56

High dose ics/laba and oral steroids

Question 57

What time of day should peak flow be measured

Answer 57

In the morning

Question 58

What step should an expert be seen for asthma management

Answer 58

Step 4 or 5

Question 59

What should you do in yellow zone

Answer 59

Increase controller med