Chapter 4: Pulmonology

Question 1

A ratio of forced expiratory volume in 1 second(FEV1) to forced vital Capacity (FVC) or FEV1/FEV6 ratio of less than 70%

Answer 1

Obstructive lung Disease

Question 2

FVC less than 80% of the predicted

With normal FEV1/FVC ratio

Answer 2

Restrictive lung disease

Question 3

Improvement in FEV1 of at-least 12% and at least 200ml from prebronchodilator to post bronchodilator measurement

Answer 3

Evidence of reversibility of airway obstruction

Question 4

Essential for detecting lung disease and for differentiating obstructive from restrictive lung disease

Answer 4

Pulmonary Function test

Question 5

Peak expiratory flow rate (PEFR)

Answer 5

Simplest PFT

Take a deep breath and blow out as hard and as fast as you can

Question 6

Gold standard test for restrictive lung dse

Answer 6

Total Lung Capacity

-measure of maximal exhaled air(FVC) plus Residual Capacity(RC)

Question 7

Obstructive Lung Diseases

Answer 7

Asthma
COPD
Chronic bronchitis

Question 8

Inflammatory episodic obstructive lung disease that is completely reversible

Answer 8

Asthma

Question 9

Most common chronic disease of childhood

Answer 9

Asthma

Question 10

Asthma

Answer 10

Complaints of chronic or acute episodic shortness of breath, wheezing, chest tightness or of chronic cough

Question 11

Bronchiolitis

Answer 11

First 2years of life

Median age of 6 months

Question 12

Most common causative organism for bronchiolitis?

Answer 12

Respiratory syncytial virus (RSV)

Others: adenovirus, influenza, parainfluenza and rhinovirus

Question 13

Cough, sneezing, rhinitis and low grade fever
Dyspnea and irritability 
Wheezing
Tachypnea
Nasal flaring

Answer 13

Bronchiolitis

Question 14

Presence of daytine sx for most days of the week and use of salbutamol inhaler for more than twice a week classify the level of asthma symptom control of the PAtient as

Answer 14

Partly controlled

Question 15

After good control is maintained for 3 months,

Answer 15

Consider stepping down

Find the minimum effective dose that controls both synptoms and exacerbations

Question 16

10y.o. With frequent dyspnea, cough and occasional noisy breathing
(+) family hx of Asthma in paternal side. What will you tell the family?

Answer 16

Asthma is a possibility but need to do lung function test

Question 17

Decreased breathsounds, vocal and tactile fremitus but hyper resonant on percussion

Answer 17

Pneumothorax

Question 18

Increased vocal and tactile fremitus, increased breath sounds and dullness on percussion

Answer 18

Consolidation and pulmonary mass

Question 19

Response to therapy to px’s with cAp

Answer 19

24-72hrs

Question 20

Prevention of COPD and Asthma

Answer 20

Smoking cessation
Promote smoke free environment
Recognize triggers that exacerbate attacks