1
Q
What is the mainstay treatment for acute asthma exacerbation?
A
Albuterol
2
Q
Which of the following is a current therapy for acute asthma exacerbations?
A
- Magnesium
3
Q
Which of the following is a complication to worry for the most if you intubate a child during an asthma attack?
A
- Pneumothorax
4
Q
What percentage of response to the methacholine is considered relevant to asthma’s diagnosis?
A
- 20%
5
Q
What is intermittent asthma?
A
- exacerbations every now and then
6
Q
What does LABA stand for?
A
- Long acting beta agonist
7
Q
What does SABA stand for
A
- Short Acting Beta Agonist
8
Q
A 7 year old uses albuterol three times a week and has night-time coughing that wakes him up twice a week. He takes his low-dose fluticasone, two puffs twice a day and is compliant. What’s the best thing to do
A
Increase his inhaler to moderate dose fluticasone.
9
Q
What is COPD?
A
COPD characterized by progressive airflow limitations, gas exchange abnormalities and hypersecretion of mucous usually induced by significant exposure to noxious particles or gases.
10
Q
Permanent abnormal enlargement or destruction of air spaces distal to the terminal bronchioles, including alveolar ducts, alveolar sacs and alveoli
A
Emphysema
11
Q
Clinically defined as a chronic productive cough for 3 consecutive months each year for 2 consecutive years with other causes excluded?
A
Chronic bronchitis
12
Q
Forced expiratory volume
A
Forced Expiratory Volume
13
Q
The measure of how much air a person can exhale during a forced breath?
A
FEV Forced Expiratory Volume
14
Q
FVC
A
Forced vital capacity
15
Q
The total amount of air exhaled during the FEV1 test
A
Forced vital capacity
16
Q
lung function value depends on the patient’s?
A
- Age
- sex
- height
17
Q
What does Peak flow measure?
A
A hand held meter used to measure how air flows from your lungs in one fast blast.
18
Q
FEV1/FVC > 80% means?
A
- normal or restrictive disorder
19
Q
FEV1/FVC ratio <80 means?
A
- obstructive disorder
20
Q
If the FEV1 improves after a bronchodilator what does that mean?
A
- The lung disease is reversible
21
Q
Concerning the sensitivity and specificity of diagnostic tests, which of the following statements is accurate?
A
Sensitivity is the proportion of people who have the disease and test positive for it.
22
Q
The following parameters can physiologically alter spirometry results, except
A
- Abdominal circumference
23
Q
Regarding spirometry results, which of the following can be interpreted from a FEV1/FVC ratio < 70%?
A
- An obstructive disorder is taking place
24
Q
What is PFT?
A
PFT can measure lung mechanics or the gas exchange/diffusion function of the respiratory system.
25
On spirometry, restrictive lung disease has a what?
1. Reduced volume low FVC
26
On spirometry obstructive lung disease has a reduced what?
1. Flow, Low FEV1
27
What are contraindications of a PFT
1. Recent eye surgery
2. abdominal aneurysms
3. hemoptysis
4. pneumothorax
5. MI
28
Volume of inhaled or exhaled air during regular respiration at rest. The normal value is 500 ml?
1. Tidal volume
29
The maximum volume of air that can be inhaled above the normal tidal inspiration the normal value is 3000 ml?
1. Inspiratory reserve volume
30
The maximum volume of air that can be exhaled after a normal tidal expiration; the normal value is 1,500 ml
1. Expiratory reserve volume
31
the volume of air present in lungs after maximum deep inspiration; the sum of all volumes: TLC = IRV + TV + ERV + RV; the normal value is 5,000–6,000 ml
1. Total lung capacity
32
the maximum volume of air exhaled after a maximum deep inspiration: VC = IRV + TV + ERV or VC = TLC – RV; the normal value is 4,500–5,000 ml
1. Vital Capacity
33
the maximum volume of air inspired after a normal tidal expiration: IC = TV + IRV; the normal value is 2,400–3,600 ml
Inspiratory capacity
34
the maximum volume of air expired after normal tidal inspiration: EC = TV+ ERV; the normal value is 1,800–2,300 ml
Expiratory capacity
35
the volume of air remaining in the lungs after normal tidal expiration: FRC = ERV + RV. FRC is an important component that maintains a continuous exchange of oxygen and carbon dioxide at the alveolar-capillary membrane. Collapse or atelectasis of the lungs leads to a reduction in FRC, causing hypoxemia and hypercarbia. The normal value is 2,500 ml.
Functional residual capacity
36
What is the normal value of the FEV1/FVC ratio?
1. The normal value is >75%
37
In obstructive lung disease the value of the FEV1/FVC ratio is?
Decreased values of less than50% suggest a severe obstruction
38
What does FEF stand for?
1. Forced mid expiratory flow
39
he maximum flow rate during the mid-expiratory part of the FVC maneuver. Expressed in L/min, it represents the status of small airways. The normal value is 300 L/min
1. Forced mid expiratory flow
40
the maximal flow rate during the FVC maneuver occurs in the initial 0.1 seconds. It gives a crude estimate of larger airway function. The normal value is 400–700 L/min
1. Peak expiratory flow rate
41
With COPD VC can be reduced in what two scenarios?
1. The patient has superimposed restrictive lung disease
| 2. The patient has significant hyper-inflation
42
What is a fixed airway obstruction?
1. Constant limitation of flow during inspiration and expiration such as stricture, goiter or stenosis
43
Reduced flow during inspiration (airways tend to collapse during inspiration due to negative transmural pressure). Positive pressure in the airway during expiration decreases obstruction, such as vocal cord palsy, obstructive sleep apnea
1. Variable extrathoracic obstruction
44
Reduction inflow is greater during expiration (high pleural pressure decreases airway diameter). During inspiration, lower pleural pressure around the airway tends to decrease obstruction, such as tracheomalacia or bronchial tumors
1. Variable intrathoracic obstruction
45
N2 washout:
The patient breathes 100% oxygen so that all nitrogen in the lungs is washed out. The difference in nitrogen volume at initial exhaled concentration and final concentration gives the value of FRC.
46
He dilution
The patient breathes from a reservoir containing a known volume of gas with a trace of helium. The inhaled helium gets diluted in the gas present in the lungs. The concentration of helium in the exhaled gas is expressed as a percentage, giving the lung volume. For example, if the patient breathes 50 mL of helium, and its concentration in the exhaled gas is 1%, the volume of the lung is 5 L.
47
Salmeterol and formoterol are what type of beta agonist?
Long acting
48
Albuterol, terbutaline, levalbuterol are what type of agonist
Short acting
49
Theophylline is what type of drug?
Methyl xanthine
50
what type of Muscarinic is ipratropium?
short acting muscarinic antagonist
51
What type of antagonist is toitropium?
long acting muscarinic antagonist
52
Cromolyn and nedocromil are what type of anti inflammatory agents?
Mast cell degranulation inhibitors
53
Taken regularly to control chronic symptoms and prevent asthma attacks — the most important type of treatment for most people with asthma
Long-term asthma control medications
54
Taken as needed for rapid, short-term relief of symptoms — used to prevent or treat an asthma attack
Quick-relief medications (rescue medications)
55
Taken regularly or as needed to reduce your body's sensitivity to a particular allergy-causing substance (allergen)
Medications for allergy-induced asthma
56
1. fluticasone
2. Budesonide
3. Mometasone
4. Beclamethasone
5. Ciclesonide
Are what type of medications
1. Inhaled corticosteroids
57
1. Montelukast
2. Zafirlukast
3. Zileuton
Are what type of medications
These medications block the effects of leukotrienes, immune system chemicals that cause asthma symptoms. Leukotriene modifiers can help prevent symptoms for up to 24 hours.
58
Why are long acting beta agonist only taken in combination with an inhaled corticosteroid?
1. Long acting beta agonist have been linked to server asthma attacks
59
1. Fluticasone and salmeterol
2. Budesonide and formoterol
3. Mometasone and formoterl
4. Fluticasone and vilanterol
are what types of medications?
1. Combination inhaler Corticosteroids and long acting beta agonist
60
These asthma medications open the lungs by relaxing airway muscles. Often called rescue medications, they can ease worsening symptoms or stop an asthma attack in progress. They begin working within minutes and are effective for four to six hours. They're not for daily use.
Albuterol (ProAir HFA, Ventolin HFA, others)
| Levalbuterol (Xopenex HFA)
61
A short acting bronchodilator that is usually prescribed for emphysema or short chronic bronchitis, but is sometimes used to treat asthma attacks . May be used either with or as an alternative to short acting beta agonist.
1. Ipratropium
62
These medications may be taken to treat severe asthma attacks. They can cause bothersome short-term side effects and more-serious side effects if they're taken for a long period. Examples include:
Long-term use of these medications can cause side effects including cataracts, thinning bones (osteoporosis), muscle weakness, decreased resistance to infection, high blood pressure and reduced growth in children.
Prednisone
| Methylprednisolone
63
sometimes used to treat asthma triggered by airborne allergens. If you have allergies, your immune system produces allergy-causing antibodies to attack substances that generally cause no harm, such as pollen, dust mites and pet dander: blocks the action of these antibodies, reducing the immune system reaction that causes allergy and asthma symptoms.
Omalizumab
64
Mepolizumab (Nucala)
Benralizumab (Fasenra)
Reslizumab (Cinqair)
Are what type of medication
A newer class of biologic drugs has been developed to target specific substances secreted by certain immune system cells. For some people, certain white blood cells, called eosinophils, build up within body tissues. Eosinophils secrete substances, called cytokines, which cause inflammation. These biological drugs target eosinophils and cytokines, reducing their numbers within the body and lowering inflammation. Taken together with other asthma medications, biologics help people with more severe forms of asthma achieve greater symptom control. These medications include
65
FEV/FVC 80%?
1. Mild
66
FEV1/FVC 50%< FEV<80%
2. Moderate
67
30%
3. Severe
68
FEV1<30%predicted
4. very severe
69
What happens to the lungs with pulmonary fibrosis?
1. The lungs shrink
70
Measure of oxygen dissolved in the blood?
1. Blood gases
71
Blood gasses are used to determine what types of respiratory failure?
1. hypoxic
| 2. Hypercapnic
72
Which of the following sums of volumes equals total lung capacity (TLC)?
Forced vital capacity and residual volume
73
Regarding pulmonary function tests, which of the following changes would be expected in patients with COPD?
An increased residual volume (RV)
74
Which of the following flow volume loop patterns would be expected in a patient with a tracheal obstruction?
Squared off pattern
75
What are the main indications for bronchoscopy?
1. New lung shadow
2. Lobar collapse
3. Hemoptysis
4. Suspected airway obstruction
76
Which of the following statements about lung volumes is TRUE?
1. Total lung capacity increases in COPD
77
Which of the blood gas results would be indicative o type 2 respiratory failure. hypoxia due to underventilation
Pa02 7.5 PaC02 8.4- ph 7.15
78
On x ray the lungs should appear what color?
1. Black
79
A cyst or pneumothorax will show what color on x ray
1. black
80
Common indications for a CT thorax are?
1. Possible lung tumors
2. Possible interstitial lung disease
3. Potential mediastinal, hilar and pleural abnormalities
4. Lobar collapse
5. Hemoptysis
81
is defined as obstructive lung disease and represents a chronic inflammation of the respiratory tract. The inflammation results in bronchial obstruction, which causes paroxysmal dyspnea. In asthmatics, the bronchial obstruction can be provoked with a methacholine challenge test and controlled with sympathomimetic drugs, bronchodilators, and corticosteroids.
Bronchial asthma
82
What divides the left lung into superior and inferior?
1. The oblique fissure
83
Where does the low airway start?
1. Trachea
84
the accumulation of air between the visceral and the parietal pleura.
Pneumothorax
85
an acute or chronic inflammation of the alveolar space and/or the interstitial lung tissue. It is one of the most frequent deadly infectious diseases in industrialized countries
PNA
86
According to Boyle's Law, what is the relationship between the pressure of a gas and the volume of its container?
inversely proportional
87
What occurs to the diaphragm when it contracts
It flattens
88
Which of the following processes occurs during exhalation?
Elastic recoil of the lungs causes them to retract
89
What is Ficks law?
1.Amount of gas transferred through a sheet of tissue (V) is proportional to:
1. The tissue area
2. A diffusion constant
3. The difference in partial pressures.
and indirectly proportional to the tissue thickness
90
What does PaCO2 mean?
PaCO2 = measured the partial pressure of carbon dioxide in arterial blood.
91
What is a normal Pa02?
Partial pressure of oxygen (PaO2) - 75 - 100 mmHg
92
What is a normal PaC02?
Partial pressure of carbon dioxide (PaCO2) - 38 - 42 mmHg.
93
What is a normal arterial blood gas?
Arterial blood pH of 7.38 - 7.42
94
What is the partial pressure of oxygen (PaO2) in deoxygenated blood?
40 mm Hg
95
What is the partial pressure of oxygen (PaO2) in oxygenated blood
100 mm hg
96
How much does the partial pressure of carbon dioxide (PaCO2) change after going through the pulmonary capillary bed?
it decreases by 5 mm hg
97
How many barriers in the normal alveolar membrane must gaseous molecules cross during diffusion?
Six: the surfactant layer, the alveolar epithelium, the interstitial space, the capillary endothelium, blood in the capillary (liquid interface), and the erythrocyte membrane.
Respiratory
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