Respiratory

Question 1

Hyper resonance is often heard in what kind of respiratory condition obstructive or restrictive?

Answer 1

Obstructive= air trapping

Question 2

what are some examples of obstructive lung disease?

restrictive?

Answer 2

obs= CF, asthma, bronchiolotis
restrictive= pneumonia

Question 3

What is the normal FEV in a health child?

Answer 3

80 or higher

Question 4

In what respiratory condition might you be able to palpate the spleen or liver?

Answer 4

obstructive resp condition, due to hyperinflated lungs pushing down on organs.

Question 5

What is one of the big concerns for asthma and longterm chronic SABA usage?

Answer 5

remodeling- thickening of the epithelial basement membranes

Question 6

which patients would require synagis (palivizumab)?

Answer 6

less than 2 with chronic lung disease, premature infant (<32 weeks) in first year of life, 32-35 seekers with risk factors (daycare, school age siblings, abnormal airways)

Question 7

what organisims are more common with lobar consolidation?

Answer 7

H.S.K
h-flu
strep pneumonia
Klebsiella

Question 8

which organisms are more common with patchy infiltrate?

Answer 8

E.S.P
E.Coli
staph aureus
Pseudomonas

Question 9

a 5 y/o patient who uses his inhaler 3-4 X a week, wakes up twice a month, has little limitation with activity would be classified as what kind of asthmatic? What would you treat him with?

Answer 9

Mild persistent

tx: low dose ICS and SABA prn

Question 10

When is the peak for a SABA, how long does it take to go into effect? what is its duration?

Answer 10

takes 5-15 to work

peak: 30 min- 2 hours
lasts: 4-6 hours

Question 11

if a patient is switched to a medium dose ICS and has improved when can they return to a low dose ICS? how often should rechecks occur?

Answer 11

3 months

recheck every 2 weeks When a change (in meds) occurs

Question 12

what is the typical FEV for a patient with moderate persistent asthma?

Answer 12

60-80

Question 13

When do you refer a patient to a pulmonologist?

Answer 13

with MODERATE persistent asthma (anything beyond mild)

Question 14

patient presents with daily symptoms, awakens at night more than once per week but not nightly, uses their inhaler daily, has some limitation with activity and an FEV of 80% what is their classification of asthma?

Answer 14

MODERATE (medium ICS, maybe a short course of steroids, refer to pulm

due to DAILY symptoms, night time awakenings more than once per week, DAILY use of inhaler, and FEV of 80% (mod FEV= 60-80)

Question 15

a pt has has asthma symptoms twice a week, and woken up at night twice this month, his activities have not had much interference, his FEV is 80% what is his asthma classification and tx?

Answer 15

intermittent, SABS use

Question 16

pt has had symptoms daily sometimes multiple times in the day, he is awoken nightly with symptoms, uses his inhaler multiple times and has an FEV of 60% what is his classification and what is his treatment?

Answer 16

sever persistent, medium ICS, oral steroids REFER

Question 17

pt has had symptoms about 2-3 times a week, and been awoken at night 3 X this month from symptoms, uses an inhaler maybe 2-3 times a week, has minor limitation in activity and an FEV of 85% what is his classification and tx?

Answer 17

Mild persistent due to symptoms happening more than twice a week, rescue inhaler usage more than twice a week.
tx: low dose ICS and SABA

Question 18

what is the name of the test done to determine if a pt has cystic fibrosis?

Answer 18

pilocarpine iontophoresis (sweat test)

• exam may use the formal name

Question 19

What age do you consider adding a LABA?

Answer 19

age 12

Question 20

what are the body systems affected with CF?

Answer 20

pulmonary, reprodructive and GI

anything with fluids/ secretions