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MCQ exam > Lungs > Flashcards

Lungs Flashcards

1
Q

what is asthma

A

chronic inflammation of disease of the airways due to airways being hyper-active to triggers. Excess mucus is produced

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2
Q

Name some non-pharmacological management for asthma

A
  • avoid allergen/ trigger
  • stop smoking
  • decrease weight if obese
  • avoid exercise in cold air
  • avoid NSAIDS and B-blockers
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3
Q

what drugs should asthmatics avoid

A

NSAIDs and Beta-blockers

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4
Q

How do reliever inhalers (SABA) work?

  • name an example of a reliever inhaler
A

Reliever inhalers produce quick symptom relief

  • e.g salbutamol/ terbutaline
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5
Q

How do preventer inhalers work?

  • name an example of a preventer inhaler
A

They work by acting on the underlying inflammation

e.g corticosteroids (e.g beclomethasone)

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6
Q

how do controller inhalers (LABA) work?

  • name an example of a controller inhaler
A

they slow onset and are long acting

e.g: salmeterol / formoterol

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7
Q

what is the first line treatment for asthma

A

a short-acting beta-2 agonist (SABA)

e.g salbutamol/terbutaline

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8
Q

when do you add a patient onto a corticosteroid

A
  • when they’re using their SABA >3 times a week and feeling symptomatic >3 times per week
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9
Q

what is a common side effect of inhaled corticosteroids

A
  • can cause oral candidiasis
  • hoarseness or abnormal voice (dysphonia)
  • adrenal suppression
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10
Q

what should patients on an inhaled corticosteroid do to prevent oral candidiasis

A

They should rinse their mouth after use

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11
Q

how should you use oral corticosteroids

A

use the lowest dose that will control symptoms for the shortest time possible

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12
Q

describe how to escalate medication for asthma

A
  • all patients on SABA.

if SABA not effective:
SABA + low dose ICS

if SABA + ICS not effective:
SABA + ICS + LABA

if SABA + ICS + LABA not effective:
- if addition of LABA show no improvement, stop it and increase dose of ICS. if LABA shows an improvement, keep it and still increase dose of ICS
consider adding trials of leukotriene antagonist, SR theophylline or LAMA

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13
Q

which drug class for asthma treatment can use a rash or sleep disturbances as a side effect

A

Leukotriene antagonists

e.g oral Montelukast and Zafirlukast

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14
Q

what does a peak expiratory flow (PEF) rate of <50% mean

A

acute severe asthma

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15
Q

what peak expiratory flow (PEF) rate should patients aim more

A

> 70

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16
Q

what FEV1/FEV should patients aim for

A

0.7

17
Q

what does a peak expiratory flow (PEF) rate of <33% mean

A

the patient has acute severe asthma and it is life-threatening

18
Q

what stage of asthma does a patient need hospitalisation

A

acute severe asthma

19
Q

what is COPD

A

obstruction of the airways due to bronchitis (chronic inflammation of the airways) and emphysema (damage to the air sacs). It is associated with an inflammatory response to the lungs

20
Q

what is a major risk factor for COPD

A

smoking

21
Q

what is a chronic productive cough a symptom of

A

COPD

22
Q

what is breathlessness and wheezing at night a common symptom of

A

Asthma

23
Q

what is the difference in breathlessness in asthma vs COPD

A
  • In asthma breathlessness is variable in asthma whereas in COPD it is persistent and progressive
  • In asthma breathlessness is common at night whereas breathlessness at night in COPD is uncommon
24
Q

how is COPD diagnosed

A
  • symptoms of COPD
  • use spirometry to take patients forced expiratory volume in 1 second (FEV1) befor and after using a bronchodilator. If there is a large response to the bronchodilators then it is asthma not COPD.
25
Q

describe how to manage stable COPD (pharmacological treatments)

A

All patients with COPD should be on a SABA

  • if breathless and no asthmatic symptoms on offer: LAMA + LABA
  • if breathless with asthmatic symptoms offer: LABA + ICS
  • if still breathless offer LAMA + LABA + ICS
26
Q

how do muscarinic antagonists work?

name a short-acting one (SAMA) and a long-acting one (LAMA)

A

they decrease reflex bronchoconstriction

short acting (SAMA): ipratropium 
long acting (LAMA): tiotropium
27
Q

what vaccines should patients with asthma and COPD have

A
  • Annual flu vaccine

- Pneumococcal vaccine

28
Q

when should antibiotics used in COPD

A
  • only during infective exacerbations
29
Q

what drug can you give to COPD patients with a chronic productive cough

A

Mucolytics (carbocisteine / mecysteine)

30
Q

what is the best inhaler technique to use a metered dose inhaler (MDI)

A

slow, deep and gentle

31
Q

what is the best inhaler technique to use a dry powder inhaler (DPI)

A

fast, deep and forceful

32
Q

why should asthmatics avoid NSAIDS

A

because they can cause bronchospasm

MCQ exam (6 decks)

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