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Lower Respiratory Disorders > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Atrovent and Spiriva are considered what types of medication

A

Anti-cholinergics

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2
Q

What type of asthma medication should be avoided in patients with hypertension, Angela, or hyper thyroidism

A

SABA

-buterols

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3
Q

What type of asthma medication should be avoided and narrow angle glaucoma, BPH, what bladder neck obstruction

A

Anti-cholinergics

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4
Q

Dyspnea, chronic cough, and chronic sputum production our key indicators of what respiratory condition

A

COPD

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5
Q

What testing is required for a diagnosis of COPD

A

Spirometery

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6
Q

What is the FEV1/FVC ratio for a COPD diagnosis?

A

Greater than .70

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7
Q

What characteristics do we use for COPD staging

A

HAG
Height
Age
Gender

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8
Q

At what age does COPD usually occur

A

Greater than age 40. Almost never see COPD before age 40.

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9
Q

What is first line treatment for COPD

A

Beta agonist such as albuterol or lev

albuterol

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10
Q

What type of respiratory drug causes tachycardia

A

Short acting beta agonists

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11
Q

What is an example of a long acting beta agonist

A

Salmeterol

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12
Q

What is the second line treatment for COPD

A

Inhaled anti-cholinergics

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13
Q

The suffix tropium is an example of which respiratory medication

A

Inhaled anticholinergic

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14
Q

What type of respiratory medication causes constipation, and increased intraocular pressure

A

Inhaled anticholinergics

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15
Q

Which respiratory medication causes memory impairment, confusion, hallucinations, dry mouth, blurred vision, urinary retention, constipation, tachycardia, and acute angle glaucoma

A

Anticholinergic medications

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16
Q

In COPD what is the only known treatment to prolong life

A

Supplemental oxygen therapy

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17
Q

Long term use of oral corticosteroids greater than 24 weeks, increases the risk of

A

Pneumonia

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18
Q

When you are treating a patient with COPD, pick an antibiotic that has coverage against

A

H. Influenzae

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19
Q

What test is the gold standard for diagnosing community acquired pneumonia

A

Chest x-ray

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20
Q

How long do you wait to repeat a chest x-ray after community acquired pneumonia treatment

A

Six weeks

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21
Q

What type of antibiotic treats percussis

A

A macrolide

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22
Q

What type of pneumonia produces rust colored sputum and is the most common cause of death from pneumonia

A

Strep pneumonia

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23
Q

What type of pneumonia is considered walking pneumonia

A

Mycoplasma pneumonia

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24
Q

Patients eight greater than 65 years old, with co-morbidities, recent three months antibiotic exposure, alcoholics, immuno suppressed, exposure to child in daycare are all at risk for

A

Drug resistant strep pneumonia

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25
Q

Abrupt onset with fever, chills, cough, pain in side or chest, rust colored sputum are all symptoms of

A

Strep pneumonia

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26
Q

How do you treat an atypical pathogen pneumonia

A

Macrolide or doxycycline

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27
Q

Young, otherwise healthy, non-smokers, community outbreak are at risk populations for what respiratory condition

A

Atypical pneumonia

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28
Q

Low-grade fever, cough, chills, headache, malaise, rash, joint aches, arrhythmias are all symptoms of what respiratory condition

A

Atypical pneumonia

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29
Q

How do you treat a patient for community acquired pneumonia and that has no signs of DRSP

A

Macrolide or Doxycycline

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30
Q

If DRSP is suspected, how do you treat

A

Respiratory quinolone such as moxifloxacin, gemifloxacin, or levofloxacin.

Or, beta lactate (pcn or ceph) plus macrolide or doxycycline

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31
Q

Patients that are Aged 19-64 with an increased risk of pneumococcal disease should receive (asthma, COPD, CV)

A

Pneumococcal vaccine PPSV 23

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32
Q

All adults greater than or equal to the age of 65 years old, or aged 19 to 64 with a asplenia, immunocompromising conditions, CSF leaks, cochlear implants, plus additional PPSV23 should receive which immunization

A

Pneumococcal vaccine PCV13 then PPSV23 in 1 year

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33
Q

What age and comorbidities are considered a vulnerable population for immunization

A

Age 65 years and older, age 19 to 64 with a comorbidity such as renal disease, rheumatoid arthritis, heart disease, asthma, COPD

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34
Q

What is curb-65

A

C is for confusion, U is for blood urea nitrogen and greater than 19.6, R is for respirations greater than 30 breaths per minute, B is for systolic blood pressure less than 90, diastolic blood pressure less than 60, age equal or greater than 65.

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35
Q

When do you repeat the pneumococcal vaccine for a high-risk patients

A

5 to 7 years as it boosts antibodies

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36
Q

How do you treat bronchitis

A

Symptomatically

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37
Q

What are laboratory tests for pertussis

A

Nasopharyngeal swab and polymerase chain reaction.

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38
Q

How is pertussis treated

A

Macrolides

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39
Q

What is the first line treatment for COPD

A

Albuterol or short acting beta agonist, then salmeterol LABA if poorly controlled

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40
Q

A patient with COPD and a smoker with pneumonia is most likely to have what type of pneumonia

A

H influenza pneumonia

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41
Q

Do you give TDap or TD to a patient aged 11 or older

A

TDap

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42
Q

What respiratory condition should be suspected in a patient that is healthy and afebrile and has been coughing for more than 2 to 3 weeks, and treated with an antibiotic that was not a macrolide and it’s getting worse

A

Pertussis, but be sure to rule out pneumonia first

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43
Q

Do use of topical nasal decongestants for more than 3 days can cause rebound nasal congestion called

A

Rhinitis medicamentosa (Afrin use)

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44
Q

A chest x-ray that shows cavitations and adenopathy and granulomas on the hila of the lungs is consistent with

A

TB

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45
Q

Is latent TB infectious

A

No

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46
Q

What drugs are first line treatment for TB

A

Isoniazid and rifampicin

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47
Q

Is TB a reportable disease

A

Yes

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48
Q

All TB patients should be tested for

A

HIV infection

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49
Q

What type of TB drug causes optic neuritis?

A

Ethambutal

Avoid if patient has abnormal vision i.e. blindness, retinal vein occlusion

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50
Q

If a TB skin test is greater than or equal to 5 mm it is consistent with

A

HIV-positive, recent contact with infectious TB cases, immunocompromised

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51
Q

A TB test that is greater than or equal to 10 mm is consistent with

A

Recent immigrants, child less than four years of age or children/adolescence exposed to high-risk adult, IV drug user, healthcare worker, homeless, employees or residence from high-risk congregate settings

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52
Q

A TB skin test results of greater than 15 mm is consistent with

A

Persons with no risk factors for TB

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53
Q

What blood test can be used in the place of the TB skin test

A

The interferon y release assay blood tests

54
Q

If a PPD result is listed as 9.5, is it positive or negative

A

Negative

55
Q

A PPD result under 10mm is

A

Negative

56
Q

Asthma is a disease of

A

Inflammation

57
Q

Cough, wheezing, shortness of breath, chest tightness, spirometry are all symptoms and tools to diagnose

A

Asthma

58
Q

In COPD, spirometry is used to demonstrate

A

Presence of airway obstruction

59
Q

In asthma, spirometry is used to demonstrate

A

Presence of airway constriction

60
Q

Asthma symptoms that occur less than or equal to two days a week is considered

A

Intermittent asthma

61
Q

Asthma symptoms that occur greater than two times a week but not daily is considered

A

Persistent asthma

62
Q

All asthma patients need to have which medication prescribed

A

Short acting beta agonist such as albuterol

63
Q

What medication do you start an asthma patient that has persistent asthma

A

Low-dose inhaled corticosteroid

64
Q

After a low-dose inhaled cortico steroid is prescribed, how do you bump up treatment

A

Step up to a medium dose inhaled corticosteroid or add a long acting beta agonist

65
Q

While gaining asthma control, when should a patient follow up

A

Every 2 to 6 weeks

66
Q

While monitoring asthma control when should a patient follow up

A

Every 1 to 6 months

67
Q

If the patient with asthma requires step down treatments how often should the patient follow up

A

Every three months

68
Q

How often should spirometry be performed on asthma patients

A

Every 1 to 2 years

69
Q

How do you treat exercise induced bronchoconstriction

A

Treat 10-15 mins before exercise, short acting beta agonist for most patients, with daily exercise consider inhaled corticosteroids

70
Q

All asthma patients should have which immunizations

A

Pneumococcal immunization and influenza immunization annually

71
Q

Should exercise be recommended for asthma patients

A

Yes

72
Q

An alternate medication for a patient with persistent asthma is

A

Theophylline

73
Q

What drug interaction does Theophylline have

A

Macrolides, quinolones, Cimetidine, anticonvulsants

74
Q

What will minimize the risk of oral thrush while using inhaled corticosteroid’s

A

A spacer

It also helps to gargle or drink water after use

75
Q

What type of medication increases the risk of asthma death

A

Long acting beta agonist

76
Q

Which asthma medication requires serum concentration monitoring

A

Theophylline

77
Q

What do you give a patient during an asthmatic exacerbation

A

Give a nebulizer treatment of albuterol. May repeat every 20 minutes for up to three doses. If Unable to use inhaled bronchodilators, give epinephrine IM

78
Q

For A patient with an asthmatic exacerbation what should be prescribed at discharge

A

Medrol dose pack or prednisone tabs 40 mg per day times four days

79
Q

What is peak expiratory flow rate based on

A

H-height
A-age
G-gender

80
Q

What is the green zone of the spirometer mean

A

80 to 100% of expected volume

Maintain or reduce medications

81
Q

What does the yellow zone of the spirometer mean

A

50-80% of expected volume

Maintenance therapy needs to be increased or patient is having an acute exacerbation

82
Q

What does the red zone of the spirometer mean

A

Below 50% of expected
If after treatment patients peak expiratory flow rate is still below 50% expected, call 911. If in respiratory distress, give epinephrine injection. Call 911

83
Q

Chronic use of which asthmatic drug causes osteoporosis, mild growth retardation and children, glaucoma, cataracts, immune suppression, hypothalmic-pituitary-adrenal suppression, and other effects

A

High dose inhaled steroids

84
Q

What is the first line treatment for severe asthmatic exacerbation or respiratory distress

A

Adrenaline injection

85
Q

If you suspect that the patient has allergic asthma, check

A

Immunoglobulin G allergy panels and one for two allergist for scratch testing and treatment

86
Q

What supplements should be prescribed for menopausal women and other high-risk patients for osteoporosis Who are on medium to high dose inhaled steroids long term

A

Vitamin D 1500 mg tabs QD and calcium

87
Q

What kind of testing should be done in males and females who are on chronic steroids

A

Bone density testing

88
Q

What eye problems occur in patients that are on long term steroids

A

Cataracts and glaucoma. Annual eye exams should be given.

89
Q

What type of breath sounds consist of a full inspiratory phase with a shortened and softer expiratory phase

A

Broncovesicular breath sounds

90
Q

When performing a respiratory assessment on a four-year-old child further valuation is warranted in the presence of

A

Supraclavicular retractions

91
Q

Dyspnea that occurs when the patient is lying down and improves when the patient sits or stands up

A

Orthopnea

92
Q

In order to locate the rib you need to palpate

A

Between the spine and the lateral chest

93
Q

What type of breath sounds are heard over the periphery of the lung fields

A

Vesicular

94
Q

When potassium in the lungs if you were hear resonance, what kind of finding is this

A

Normal

95
Q

When percussing the lungs if Dullness is found, what should be considered

A

A lung with fluid or solid tissue replacing air

96
Q

A condition associated with a chronic cough that produces copious amounts of purulent sputum is most likely

A

Bronchiectasis

97
Q

Respiratory effort in the neonate is initiated at birth as a result of

A

Chemical, thermal, and mechanical factors

98
Q

The hilar region of the lungs describes

A

The area around the heart

99
Q

Breath sounds heard on the chest over the hilar region are

A

Bronchovesicular

100
Q

Which technique that determines whether the tissues in the chest are airfilled, fluid filled, or solid

A

Percussion

101
Q

Where is the coastal angle located

A

Where right and left costal margin’s form an angle where they meet at the xiphoid process

102
Q

Tachypnea in a child with a fever is related to

A

The child’s febrile state

103
Q

When percussing the chest in a patient who has left-sided heart failure the sound emanated would be

A

Resonant

104
Q

Breath sounds consisting of a full inspiratory and expiratory phase with the inspiratory face usually being louder and normally heard over the trachea and larynx are considered

A

Bronchial

105
Q

Breath sounds auscultated over the periphery of the lung fields are quiet and wispy during the inspiratory phase followed by a short, almost silent expiratory phase. These breath sounds are considered

A

Vesicular

106
Q

Where is the angle of Louis located

A

On the manubrium and body of the strernum

107
Q

Pain from pleurisy may be referred to that

A

Epigastric area

108
Q

The lower tip of the scapula is located

A

Around the seventh or eighth rib

109
Q

Factors that aggravate costochondritis may include

A

Movement of the chest, trunk, and arms

110
Q

On auscultation of the chest, if the patient says 99 and it is clearly heard, this is indicative of

A

Lung density in the area

111
Q

Breath sounds that are normally audible over the hilar region of the chest is termed

A

Bronchovesicular

112
Q

To locate the 12 rib, palpate

A

Between the spine and the lateral chest

113
Q

Breath sounds heard over the periphery of the lung fields are

A

Vesicular

114
Q

Which cardiovascular medication can worsen COPD

A

Propanolol or beta blockers

115
Q

What type of respiratory medications can cause tachycardia

A

Albuterol or inhaled beta agonists

116
Q

The chest circumference of a 12 month old is

A

Equal to head circumference

117
Q

Which immunization has shifted the pathogenesis see if you were cases of streptococcus pneumoniae

A

Pneumococcal immunization

118
Q

How do you treat bronchiolitis in a child

A

Symptomatic treatment

119
Q

What diagnostic test is required for a definitive diagnosis of TB

A

Sputum specimen

120
Q

Which asthma medication is linked to an increase in the risk of sudden death if used alone

A

Long acting bronchodilator

121
Q

What respiratory disease can cause anxiety or depression

A

COPD

122
Q

What antihypertensive medication should be avoided in patients with a history of emphysema

A

Beta blockers

123
Q

What is the minimum size of induration considered positive for PPD

A

5mm

124
Q

What are the three stages of pertussis

A

Catarrhal
Paroxysmal
Convalescent

125
Q

An autosomal recessive disorder such as cystic fibrosis is expressed in the offspring when

A

Both parents carry the gene

126
Q

What condition is associated with mucus Production greater than three months per year for at least two consecutive years

A

Chronic bronchitis

127
Q

A call is received from a nursing home reporting that an 86-year-old resident has become weak, dizzy, and short of breath over the past several hours. The patient has tachycardia, crackles, a wet cough, generalized pallor, and circumoral cyanosis. What is the most likely diagnosis

A

CHF

Left sided

128
Q

Is tuberculosis only in the lungs

A

No it can occur in the kidneys brain lymph nodes adrenals bone and more

129
Q

A patient that is taking a long term antihistamine is in need of what supplement

A

Iron

130
Q

When should influenza vaccine be given

A

Influenza vaccine should be given annually to all persons 65 years or older, and to persons six months or older who are in chronic care facilities or who suffer from chronic cardio pulmonary disorders, metabolic disorders, hemoglobin pathology, or immunosuppression

131
Q

When is the pneumococcal vaccine recommend

A

Age 65 and over

Lower Respiratory Disorders (2 decks)

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