Respiratory Quiz Part 2

Question 1

Which medication is most effective for symptomatic treatment of allergic rhinitis?

A) Oral first generation antihistamine like diphenhydramine
B) An oral second generation antihistamine like fexofenadine
C) An intranasal corticosteroid
D) An intranasal antihistamine

Answer 1

C - antihistamines are effective for treatment of nasal itching, sneezing and rhinorrhea; they are much less effective for nasal congestion. Oral first-generation antihistamines can cause sedation and CNS impairment and are generally not recommended.

Question 2

Oral second generation antihistamines are less likely to cause sedation than first generation medications. Second generation antihistamines are:

A) Recommended for treatment of mild episodic allergic rhinitis
B) Are effective for relief of nasal congestion
C) Have added benefits when added to a patient managed with intranasal corticosteroids
D) All of the above

Answer 2

A - oral second generation antihistamines can also reduce ocular symptoms. Many second-generation antihistamines, such as fexofenadine, loratadine, and cetirizine are available OTC.

Question 3

Intranasal antihistamines

A) Are less effective than oral antihistamines
B) Can cause dysgeusia (abnormal taste)
C) Do not require a prescription
D) Have a delayed onset of effect when compared to oral antihistamines

Answer 3

B - intranasal antihistamines are only available by prescription. They have a rapid onset of action and are as effective as their oral counterparts. In addition to dysgeusia, they can cause nasal discomfort, epistaxis, headache, and sedation.

Question 4

The oral second generation antihistamine least likely to cause sedation even at high doses is:

A) Cetirizine
B) Fexofenadine
C) Levocetirizine
D) Loratadine

Answer 4

B - loratadine and desloratadine do NOT cause CNS impairment or sedation at recommended doses, but they can at higher doses

Question 5

T or F: Oral phenylephrine is an effective decongestant

Answer 5

False

Question 6

Glucocorticoids are also useful in the treatment of:

A) CINV (Chemo-induced nausea and vomiting)
B) Primary hypertension
C) Type 2 diabetes
D) Parkinson’s disease

Answer 6

A

Question 7

Your patient with systemic lupus erythematosus is successfully maintained on moderate to high daily doses of prednisone over a period of nearly a year. You decide its time to stop her prednisone. Your adviser/colleague reminds you to gradually taper the dose of prednisone before stopping her prednisone all together. Tapering of glucocorticoids promotes the gradual recovery of which system?

A) Hypothalamic - pituitary - adrenal
B) Pancreatic beta cells - insulin release
C) Hematopoiesis
D) Control of vasopressin

Answer 7

A - exogenous glucocorticoids act on the hypothalamus and pituitary to suppress production of CRH and ACTH which suppresses endogenous corticosteroids. Recovery can take many weeks to months.