COPD

Question 1

usually observed in patients with 1AT deficiency,

Answer 1

Panacinar emphysema

Question 2

usually observed in patients with 1AT deficiency,

Answer 2

Panacinar emphysema

Question 3

usually observed in patients with 1AT deficiency,

Answer 3

Panacinar emphysema

Question 4

patients with predominant emphysema

thin, noncyanotic at rest and have prominent use of accessory muscles

Answer 4

pink puffers

Question 5

patients with predominant emphysema

thin, noncyanotic at rest and have prominent use of accessory muscles

Answer 5

pink puffers

Question 6

most likely explanation for newly developed clubbing in COPD patient

Answer 6

development of lung cancer

Question 7

hallmark of COPD

Answer 7

airflow obstruction

Question 8

important prognostic factor in COPD and is the basis for the Global Initiative for Lung Disease (GOLD) redundant classification

Answer 8

degree of airflow obstruction

Question 9

better predictor of COPD mortality rate than pulmonary function alone

Answer 9

airflow obstruction, exercise performance, dyspnea, and body mass index

Question 10

GOLD classification

Stage I

Answer 10

Mild severity

FEV1/FVC

Question 11

GOLD classification

Stage 0

Answer 11

At risk
Chronic cough, sputum production
Normal spirometry

Question 12

GOLD classification

Stage IIa

Answer 12

FEV1/FVC

Question 13

GOLD classification

Stage III

Answer 13

FEV1/FVC

Question 14

GOLD classification

Stage IV

Answer 14

FEV1/FVC

Question 15

change in pH per rise in PaCO2

Answer 15

0. 08 units/10 mmHg acutely “Eight-cute”

0. 03 units/10 mmHg (chronic state)

Question 16

ventilatory failure

Answer 16

PCO2 >45 mmHg

Question 17

current definitive test for establishing the presence or absence of emphysema in living subjects

Answer 17

Computed tomography (CT) scan

Question 18

Only three interventions demonstrated to influence the natural history of patients with COPD

Answer 18

1. smoking cessation
2. oxygen therapy in chronically hypoxemic patients
3. lung volume reduction surgery

Question 19

Evidence for tiotropium in COPD

Answer 19

trend toward reduced mortality rate in the tiotropium-treated patients that approached, but did not reach, statistical significance

Question 20

Available data suggest that inhaled glucocorticoids reduce COPD exacerbation frequency by ___

Answer 20

25%

Question 21

Evidence for theophylline in COPD

Answer 21

produces modest improvements in expiratory flow rates and vital capacity and a slight improvement in arterial oxygen and carbon dioxide levels in patients with moderate to severe COPD

Question 22

common SE theophylline

Answer 22

Nausea

Question 23

N-acetyl cysteine in COPD

Answer 23

mucolytic and antioxidant properties

Question 24

Patients are excluded Lung Volume Reduction Surgery (LVRS)

Answer 24

significant pleural disease
pulmonary artery systolic pressure >45 mmHg
extreme deconditioning
congestive heart failure, or other severe comorbid conditions

Question 25

criteria for Lung transplantation

Answer 25

lung transplantation should be

Question 26

oral glucocorticoids in exacerbation | 30-40 mg of oral prednisolone or its equivalent x 10-14 days

Answer 26

reduce the length of stay hasten recovery reduce the chance of subsequent exacerbation or relapse for a period of up to 6 months

Question 27

Contraindications to noninvasive positive-pressure ventilation (NIPPV)

Answer 27

> cardiovascular instability > impaired mental status/unacooperative > copious secretions or unable to clear secretions > craniofacial abnormalities/ trauma precluding effective fitting of mask > extreme obesity > significant burns

Question 28

most frequently reported acute complication of glucocorticoid treatment

Answer 28

Hyperglycemia

Question 29

most frequently reported acute complication of glucocorticoid treatment

Answer 29

Hyperglycemia

Question 30

Chronic obstructive pulmonary disease (COPD) definition

Answer 30

disease state characterized by airflow limitation that is not fully reversible (http://www.goldcopd.com/)

Question 31

COPD

Answer 31

emphysema chronic bronchitis small airways disease

Question 32

the most highly significant predictor of FEV1

Answer 32

pack-years of cigarette smoking

Question 33

allele is associated with normal 1AT levels

Answer 33

M allele

Question 34

associated with slightly reduced 1AT levels

Answer 34

S allele

Question 35

associated with markedly reduced 1AT levels

Answer 35

Z allele

Question 36

associated with markedly reduced 1AT levels

Answer 36

Z allele

Question 37

most common form of severe 1AT deficiency

Answer 37

Individuals with two Z alleles or one Z and one null allele (PiZ)