Respiratory Disorders

Question 1

Three methods to prevent asthma exacerbations

Answer 1

1) Control of triggers
2) Smoking Cessastion
3) Immunization

Question 2

Drug used for provocative asthma testing

Answer 2

Methacholine

Question 3

Name Meds in the Following Classes

1) Short Acting Beta2 Agonist (SABA)
2) Inhaled Corticosteroids (ICS)
3) Long Acting Beta2 Agonist (LABA)
4) Leukotriene Receptor Antagonist (LRTA)
5) Anticholinergics
6) Combo ICS + LABA
7) Combo Anticholinergic + SABA

Answer 3

1) Salbutamol (Ventolin, Airomir), Terbutaline (Bricanyl)
2) Fluticasone (Flovent), Budenoside (Pulmacort), Qvar
3) Formoterol (Oxeze, Foradil), Salmeterol (Serevent)
4) Montelukast (Singulair),
5) Atrovent, Spiriva
6) Advair, Symbicort
7) Combivent

Question 4

Six steps of pharmacotherapy for Asthma

Answer 4

1) SABA PRN for intermittent symptoms
2) Add ICS (low dose)
3) Add LABA (sl-LTRA)
4) High dose ICS + LABA
5) Oral prednisone
6) Anti-IgE therapy

Question 5

Adjunctive Medication for Rhinitis & Nasal Polyps

Answer 5

Nasal corticosteroid (avamys, etc)

Question 6

Four therapies for acute asthma exacerbations

Answer 6

SABA, Systemic CS, Inhaled anticholinergics, O2

Question 7

At what age can you diagnose asthma in a child?

Answer 7

Kids >3y/o

Question 8

In kids, what’s a predictor of persistent asthma?

Answer 8

Atopy

Question 9

How do you differentiate Asthma and COPD (spirometry)

Answer 9

Asthma is reversible after SABA administration

Question 10

Parameters for Determining Acceptable Asthma Control

1) Daytime Symptoms
2) Nightime Symptoms
3) Physical Activity
4) Exacerbations
5) School or Work Absence
6) Need for SABA
7) FEV1 or PEF

Answer 10

1) 90% of personal best

Question 11

What must you always add to LABA therapy and why?

Answer 11

ICS d/t increase mortality when using LABA alone

Question 12

Five steps of pharmacotherapy for COPD

Answer 12

1) SABA +/- regularly schedules short acting anticholinergic
2) SABA + Long acting inhaled anticholinergic
3) SABA + LABA + Long acting inhaled anticholinergic
4) ICS if exacerbations occur
5) Theophiline

Question 13

Treatment of Acute COPD exacerbations (4)

Answer 13

1) Bronchodilators
2) ABX
3) Systemic CS
4) O2

Question 14

Key symptoms seen with COPD (2)

Answer 14

SOB and activity limitation

Slow manifestation

Question 15

What 2 things are required to establish diagnosis of COPD?

Answer 15

1) FEV/FVC ration <80% of predicted value

Question 16

Tuberculosis

Answer 16

1) Chronic bacterial infection caused by Mycobacterium tuberculosis
2) Person with latent TB does not have active disease and is not contagious
3) Pt w/ positive TB skin tests should have chext x-ray to r/o active disease
4) Causes malaise, wt loss, fever, night sweats, & chronic cough
5) Treat latent TB

Question 17

Community Acquired Pneumonia

Answer 17

1) Most common cause of death from infectious disease
2) Majority caused by S. Pneumoniae, but also caused by H. Ingluenzae & rarely Legionella spp.
3) Symptoms include cough, dyspnea, sputum production, & pleuritic chest pain