COPD

Question 1

Define emphysema

Answer 1

enlargement of distal airways
destruction of acini
absence of fibrosis

Question 2

DLCO in emphysema

Answer 2

reduced

Question 3

Sensitivity of CXR for COPD

Answer 3

not good

Question 4

Indications for oxygen therapy in COPD

Answer 4

PaO2< 55 or SpO2 < 88%
or
PaO2<90% if pulmonary HT,Polycythemia,heart failure is present

Question 5

Vaccinations in COPD

Answer 5

influenza

pneumococcal

Question 6

Indication for LVRS in emphysema

Answer 6

upper lobe predominant emphysema

Question 7

DD for acute exacerbation of COPD

Answer 7

pneumothorax
pneumonia
pleural effusion
CCF
cardiac ischemia
pulmonary embolism

Question 8

Role of antibiotic therapy in Acute exacerbation of COPD

Answer 8

increased dyspnea, sputum volume, and sputum purulence

pts with a need for mechanical ventilation

Question 9

Components of BODE index

Answer 9

BMI
FEV1
MMRC grading
Exercise tolerance(distance walked in 6 min)

Question 10

Infections predisposing to asthma

Answer 10

RSV

rhino virus

Question 11

Drugs that can cause exacerbation of asthma

Answer 11

Aspirin and other NSAID

betablockers

Question 12

Conditions associated with asthma

Answer 12

Rhinosinusitis
polyps
OSA
obesity
vocal cord dysfunction
GERD

Question 13

Definition of reversibility in asthma

Answer 13

Improvement in FEV1 of 12% and 200 cc after 2 to 4 puffs of short acting bronchodilator therapy

Question 14

Methacholine challange is considered positive if there is a drop in FEV1 of

Answer 14

20%

Question 15

LTRM should be strongly considered for patients with

Answer 15

aspirin induced asthma

Question 16

cromolyn is first line for

Answer 16

exercise induced asthma

Question 17

mech ventilation principles in asthma

Answer 17

large ET tube >7.5
low tidal volume
low RR
prolonged expiratory phase with high inspiratory flow
permissive hypercapnia

Question 18

side effects of SABA

Answer 18

tremor 
anxiety
tachycardia
low K+ and Mg+
long QT
mild lactic acidosis

Question 19

adverse effects of ziluton

Answer 19

reversible hepatitis

Question 20

risk factors associated with OSAS

Answer 20

obesity
nasal block
hypothyroidsm
acromegaly
adenoidal or tonsillar hypertrophy
retrognathia
micrognathia
macroglossia
Vocal cord paralysis

Question 21

DD for daytime sleepiness

Answer 21

OSAHAS
Periodic limb movement disorder
narcolepsy
sleep deprivation

Question 22

AHI of more than _______ with symptoms indicates sleep apnea

Answer 22

5

Question 23

contraindications to mandibular repositioning devices

Answer 23

TMJ dysfunction
bruxism
full dentures
inability to protrude mandible

Question 24

Complications of uvulopalatopharyngoplasty

Answer 24

nasopharyngeal stenosis
foreign body stenosis
change in voice
velopharyngeal insufficiency

Question 25

Definition of pulmonary HT

Answer 25

sustained elevation of Mean pulmonary artery pressure >= 25 mm Hg at rest

Question 26

Causes of acute PHT

Answer 26

Acute PE
Pulmonary edema
ARDS

Question 27

Important clue for hypoventilation syndrome

Answer 27

elevated PaCO2

Question 28

ATRIAL septostomy

Answer 28

palliative procedure performed in right heart failure

Question 29

drug interactions of PDE5 inhibitors

Answer 29

protease inhibitors

nitrates

Question 30

ILDs with expiratory airflow obstruction

Answer 30

sarcoidosis

hypersensitivity pneumonitis

Question 31

ILDs associated with smoking

Answer 31

DIP
Pulmonary Langerhan cell histiocytosis
Respiratory bronchiolitis-ILD

Question 32

antifibrotic drug

Answer 32

pirfenidone

Question 33

Lofgren syndrome

Answer 33

arthritis
erythema nodosum
B/L hilar adenopathy