Respiratory System - Finals Paper One

Question 1

What is a feature of life-threatening asthma attacks?

Answer 1

Normal pCO2 Levels

Question 2

What is a feature of a near-fatal asthma attack?

Answer 2

Raised pCO2 Levels

Question 3

When are ABGs used to investigate acute asthma attacks?

Answer 3

Saturations < 92%

Question 4

What are the four admission criteria for acute asthma?

Answer 4

Life Threatening

Severe With Management Failure

Previous Near-Fatal Attack

Pregnancy

Question 5

When is nebulised SABA used to manage acute asthma attacks?

Answer 5

Life Threatening

Question 6

What corticosteroid is used to manage acute asthma attacks?

Answer 6

Oral Prednisolone

Question 7

When is nebulised ipratropium bromide used to manage acute asthma attacks?

Answer 7

Severe/Life-Threatening Astma

Question 8

What ventilation method is recommended in acute asthma?

Answer 8

Intubation & Ventilation

Question 9

What are the two management options of mild to moderate asthma attacks in children?

Answer 9

Beta-2 Agonist Bronchodilator

Oral Prednisolone

Question 10

What are the two management options of mild to moderate asthma attacks in children?

Answer 10

Beta-2 Agonist Bronchodilator

Oral Prednisolone

Question 11

What spirometry reversibility testing result indicates asthma?

Answer 11

FEV1 > 12% improvement

FEV1 > 200ml

Question 12

When bronchodilator reversibility is negative, what is the most appropriate next step?

Answer 12

Fractioned Exhaled Nitric Oxide Testing

Question 13

What is step one of asthma management in adults?

Answer 13

Short-Acting Beta Agonist

Question 14

What is step two of asthma management in adults?

Answer 14

Short-Acting Beta Agonist

Low Dose Inhaled Corticosteroid

Question 15

What is step three of asthma management in adults?

Answer 15

Short-Acting Beta Agonist

Low Dose Inhaled Corticosteroid

Leukotriene Receptor Antagonist

Question 16

What is step four of asthma management in adults?

Answer 16

Short-Acting Beta Agonist

Low Dose Inhaled Corticosteroid

Long-Acting Beta Agonist

*The Leukotriene Receptor Antagonist should be continued dependent on the patient’s response *

Question 17

What is the most appropriate step down treatment of asthma?

Answer 17

Reduce inhaled corticosteroid dose by 25% - 50%

Question 18

What is the most appropriate management step when occupational asthma is suspected?

Answer 18

Specialist Referral

Question 19

What is step one of asthma management in children < 5 years old?

Answer 19

Short-Acting Beta Agonist

Question 20

What is step two of asthma management in children < 5 years old?

Answer 20

Short-Acting Beta Agonist

8 Week Trial Moderate Dose Inhaled Corticosteroid

Question 21

What is step three of asthma management in children < 5 years old?

Answer 21

Short-Acting Beta Agonist

Low Dose Inhaled Corticosteroid

Leukotriene Receptor Antagonis

Question 22

What is the most common organism associated with bronchiectasis?

Answer 22

Haemophilus Influenzae

Question 23

What is an indicator of surgical management of bronchiectasis?

Answer 23

Localised Disease

Question 24

What is the most common cause of infective exacerbations of chronic obstructive pulmonary disease?

Answer 24

Haemophilus Influenzae

Question 25

What are the two management options of acute chronic obstructive pulmonary disease exacerbations?

Answer 25

Nebulised Bronchodilator Oral Prednisolone for 5 Days

Question 26

When are antibiotics used to manage acute exacerbations of chronic obstructive pulmonary disease?

Answer 26

When sputum is purulent or there are clincial features of pneumonia

Question 27

What are the three first line antibiotics used to manage acute exacerbations of chronic obstructive pulmonary disease?

Answer 27

Amoxicillin Clarithromycin Doxycycline

Question 28

What ventilation method is used to manage acute chronic obstructive pulmonary disease exacerbations with type two respiratory failure?

Answer 28

Non-invasive ventilation

Question 29

What should be offerred to those with frequent chronic obstructive pulmonary disease exacerbations?

Answer 29

A home supply of prednisolone and an antibiotic

Question 30

What is used to determine the severity of chronic obstructive pulmonary disease?

Answer 30

FEV1

Question 31

What FEV1 result indicates mild/stage one chronic obstructive pulmonary disease?

Answer 31

> 80%

Question 32

What FEV1 result indicates moderate/stage two chronic obstructive pulmonary disease?

Answer 32

50% - 79%

Question 33

What FEV1 result indicates severe/stage three chronic obstructive pulmonary disease?

Answer 33

30% - 49%

Question 34

What FEV1 result indicates very severe/stage four chronic obstructive pulmonary disease?

Answer 34

< 30%

Question 35

What are the two first line management options of chronic obstructive pulmonary disease?

Answer 35

Short-Acting Beta2-Agonist OR Short-Acting Muscarinic Antagonist

Question 36

Name a short-acting muscarinic antagonist inhaler used to manage chronic obstructive pulmonary disease

Answer 36

Ipratropium

Question 37

What is the second line management options of chronic obstructive pulmonary disease - in those with no asthmatic features?

Answer 37

Add Long-Acting Beta2 Agonist AND Add Long-Acting Muscarinic Antagonist *When taking a short-acting muscarinic agonist, discontinue and switch to short-acting beta2 agonist*

Question 38

Name a long -acting beta2 agonist inhaler used to manage chronic obstructive pulmonary disease

Answer 38

Formoterol

Question 39

Name a long-acting muscarinic antagonist inhaler used to manage chronic obstructive pulmonary disease

Answer 39

Tiotropium

Question 40

What are the four asthmatic features of chronic obstructive pulmonary disease?

Answer 40

A previous diagnosis of asthma/atopy A higher blood eosinophil count A substantial variation in FEV1 over time > 400 ml A substantial diurnal variation in peak expiratory flow > 20%

Question 41

What is the second line management options of chronic obstructive pulmonary disease - in those with asthmatic features?

Answer 41

Long Acting Beta2 Agonist AND Inhaled Corticosteroid

Question 42

What is the third line management options of chronic obstructive pulmonary disease - in those with asthmatic features?

Answer 42

Long Acting Beta2 Agonist AND Inhaled Corticosteroid AND Long Acting Muscarinic Antagonist

Question 43

What prophylactic antibiotic is used to manage chronic obstructive pulmonary disease?

Answer 43

Azithromycin

Question 44

What investigation should be conducted prior to azithromycin administration? Why?

Answer 44

ECG Scan Side Effect = Prolonged QT

Question 45

Which six feautres should indicate assessment for long term oxygen therapy in chronic obstructive pulmonary disease?

Answer 45

FEV1 < 30% O2 < 92% Cyanosis Polycythaemia Raised JVP Ankle Oedema

Question 46

When is long term oxygen therapy used to manage chronic obstructive pulmonary disease?

Answer 46

pO2 < 7.3 (x2 positive results) OR pO2 7.3 - 8 with one of the following... * Secondary Polycythaemia * Peripheral Oedema * Pulmonary Hypertension

Question 47

What heel prick test result indicates cystic fibrosis?

Answer 47

Increased Immunoreactive Trypsinogen (IRT) Levels

Question 48

What is the dietary management option of cystic firbosis?

Answer 48

High calorie and high fat diet, with pancreatic enzyme supplemetation for every meal

Question 49

What is the management option used to reduce chest infections in cystic fibrosis?

Answer 49

Advise individuals to minimise contract with each other due to the risk of cross infection

Question 50

What antibotic is used to manage Pseudomonas Aeruginosa infection in cystic fibrosis?

Answer 50

Oral Ciprofloxacin

Question 51

Which two organisms are associated with the greatest mortality risk in cystic fibrosis?

Answer 51

Pseudomonas Bulkholderia