Obstructive Diseases Quiz Questions Lecturio
Which of the following criteria is not needed in the specific management of asthma? DLCO Cor pulmonale History of smoking History of alcoholism Chronic productive cough
History of alcoholism
hich of the following is NOT a finding on the X-ray of a patient with severe emphysema? Reduced lung markings Boot shaped heart Flattened diaphragms Increased intercoastal distance Prominent bullae
Boot shaped heart
Which of the following antibiotics is useful in the treatment of COPD with exacerbation due to an infective cause? Ampicillin Azithromycin Vancomycin Cephalosporin Rifampicin
Azithromycin
Which of the following parameters are NOT useful for monitoring the severity of COPD? How long the patient has been diagnosed with COPD Oxygen saturation level Blood gas analysis of the patient Drowsiness of the patient Patient's ability to speak in full sentences
How long the patient has been diagnosed with COPD
Which of the following chest x-ray findings is not seen in emphysema? Hypoinflation Hyperinflation Hyperlucency Right ventricular hypertrophy
Hypoinflation
What happens to the blood levels of oxygen and carbon dioxide in a patient with compensatory hyperventilation as a result of emphysema? Hypoxemia with or without hypercapnia Hypoxemia with hypercapnia Normal oxygen with hypercapnia Normal oxygen without hypercapnia Hypoxemia without hypercapni
Hypoxemia with or without hypercapnia
Which of the following gastrointestinal diseases is associated with bronchiectasis? Diverticulosis Diverticulitis Irritable bowel syndrome Colon cancer Inflammatory bowel disease
IBD
Which of the following is used to inhibit the degranulation of mast cells? IgD therapy IgM therapy IgG therapy IgA therapy IgE therapy
IgE
Which of the following is not used in the treatment of moderate persistent asthma? High dose ICS Leukotriene modifier IgE therapy Theophylline Long-acting beta agonist
IgE therapy
Which of the following treatments improves long term survival in patients with COPD? Long acting inhaled B1 agonists Lung volume expansion surgery Long term oxygen treatment for patients with respiratory failure Oral aminophyllines
Long term oxygen treatment for patients with respiratory failure
Which of the following is an unlikely presentation in bronchiectasis? Fever 3 months of productive cough over 2 consecutive years Frequent respiratory infections Chronic productive cough Shortness of breath
3 months of productive cough over 2 consecutive years
What is the amount of FEV1 lost over every year in a patient over the age of 40 who is a non-smoker or does not have COPD? < 50 mls/year < 30 mls/ year < 40 mls/year < 60mls/year
< 30 mls/ year
Which of the following statements is correct in the diagnosis of asthma? A decrease in RV after exposure to methacholine. A decrease in TLC after exposure to methacholine. A decrease in FEV1 after exposure to methacholine. An increase in FEV1 after exposure to methacholine. No change in FEV1 after exposure to methacholine.
A decrease in TLC after exposure to methacholine.
Which of the following enzymes is blocked when corticosteroids are administered in a patient with asthma? Phospholipase B Phospholipase D Phospholipase A2 Phospholipase C Phospholipase A1
A2
Which area of the lung fields will show emphysematous changes on chest X-ray of a patient with alpha-1 antitrypsin deficiency? Only in the hilar region of the lungs Entire lung fields Apical Basal Middle lobe
Basal
Which of the following drugs is given to treat COPD? Beta-1 agonists Beta-2 agonists Alpha-1 blocker Alpha-1 agonists Alpha-2 agonists
Beta-2 agonists
What is the investigation of choice to delineate type 1 and type 2 respiratory failure post complication of COPD? Serum electrolytes Chest X-ray Pulmonary function tests Blood gas analysis CT scan
Blood gas
ich of the following pulmonary function test values will decrease in COPD? FVC FEV1 FEV1/FVC All of the listed options Peak expiratory flow rate
All
Which of the following statements regarding COPD is FALSE? Alpha-1-antitrypsin deficiency causes early onset emphysema Low birth weight is a risk factor for COPD All patients with COPD were heavy smokers at some point in their life COPD is characterized by an increased rate in the annual fall in FEV1
All patients with COPD were heavy smokers at some point in their life
Which of the following neutralizes the effects of elastase? Surfactant Enolase Protease Mucopolysaccharides Alpha-1 antitrypsin
Alpha-1 antitrypsin
Which of the following is the diagnostic test in the management of alpha-1 antitrypsin deficiency? Pulmonary function testing Lung biopsy Apical emphysematous changes on chest x-ray Alpha-1 antitrypsin evaluation Basal emphysematous changes on chest x-ray
Alpha-1 antitrypsin evaluation
Which of the following is not used in the management of an acute flare of asthma? Inhaled steroids Antibiotics Oxygen Oral steroids Albuterol
Antibiotics
Which of the following is LEAST likely to be an etiology of bronchiectasis? Allergic bronchopulmonary aspergillosis Rheumatoid arthritis Asthma Chronic obstructive pulmonary disease Cystic fibrosis
Asthma
Which of the following is the most effective initial step in the management of asthma? Long-acting bronchodilator Oral steroids IgE therapy Avoid triggers Inhaled steroids
Avoid triggers
A 25-year-old man presents with infertility. A workup reveals dextrocardia. Which of the following complications is most likely associated with this condition? Interstitial lung disease Emphysema Bronchopulmonary asthma Bronchiectasis Sinonasal polyposis
Bronchiectasis Recurrent lower respiratory tract infection leads to bronchiectasis. An adult person commonly seeks medical help because of infertility.
Which of the following statements is correct regarding chronic bronchitis and bronchiectasis? Chronic bronchitis will have more sputum production, and more likely to have Pseudomonas infection. Bronchiectasis will have less sputum production, and more likely to have Pseudomonas infection. Bronchiectasis exhibits 3 months of symptoms for 2 consecutive years. Bronchiectasis will have more sputum production, and more likely to have Pseudomonas infection. Bronchiectasis will have more sputum production, and less likely to have Pseudomonas infection.
Bronchiectasis will have more sputum production, and more likely to have Pseudomonas infection.
Which of the following is NOT a useful diagnostic tool for COPD? Pulmonary function tests Bronchoscopic biopsy CT scan Chest X-ray Spirometric analysis
Bronchoscopic biopsy
A 60-year-old male presents with a history of productive cough for 5 months not improving with inhaled beta agonists. He is afebrile, tachypneic, breathing through pursed lips on expiration, and engaging his sternocladomastoid muscles with each breath. On exam, you note that he has a "barrel shaped" chest, a prolonged expiratory phase, and quiet lung sounds. What is the most likely diagnosis for this patient? COPD Pneumoconiosis Pneumonia Tuberculosis Asthma
COPD
Among the following respiratory ailments, which is the most common cause of admission in industrialized countries? Tuberculosis Sarcoidosis Interstitial lung disease Lung cancer COPD
COPD
Which of the following statements is FALSE? COPD causes a purely restrictive pattern on spirometry Some patients with COPD have a reduced transfer factor In patients with COPD, routine blood tests may be normal or only show mild abnormalities Absence of wheeze on auscultation does not exclude COPD as a diagnosis
COPD causes a purely restrictive pattern on spirometry
Which of the following statements is FALSE regarding COPD? COPD is specific to smokers only COPD can present as a combination of chronic bronchitis, emphysema and asthma COPD is the second most common lung disease in the world COPD usually involves the terminal bronchioles with slow irreversible airway obstruction COPD does not effectively respond to steroids
COPD is specific to smokers only
A medical student evaluating a new patient produces a differential diagnosis inclusive of pulmonary edema, pulmonary embolism, pneumonia, pneumothorax, and COPD. What is the appropriate initial test to begin to narrow down the differential? Arterial blood gas analysis Spirometry Chest X-ray MRI Peak expiratory flow meter
CXR
Which of the following is NOT a common complication of emphysema? Pneumothorax Cavitation Respiratory failure Pneumonia Bronchiectasis
Cavitation
A 45-year-old man with a history of frequent respiratory tract infections is brought to the ER with shortness of breath. He complains of a productive cough for the past several months. A CT scan of the chest shows severe dilation of the bronchi. Which of the following must be ruled out before making a diagnosis of bronchiectasis? Chronic bronchitis Chronic obstructive pulmonary disease Emphysema Interstitial lung disease Asthma
Chronic bronchitis
Which pneumoconiosis is commonly associated with COPD? Byssinosis Asbestosis Silicosis Coal worker's lung Bagassosis
Coal worker's lung
Which of the following is not a differential diagnosis in a patient presenting with wheezing? Congestive heart failure ABPA Congenital heart disease COPD Pulmonary embolism
Congenital heart disease
A chronic smoker presents with dyspnea and pedal edema. He appears to have lost weight from the previous appointment. His JVP is raised on examination and you note abdominal ascites. To which of the following complications of COPD can these symptoms be attributed to? Respiratory cachexia Lung cancer Tuberculosis Cor bovium Cor pulmonale
Cor pulmonale
Which of the following is the diagnostic test of choice for bronchiectasis? High-resolution CT of the chest Bronchoscopy Lung biopsy CT of the chest X-ray of the chest
High-resolution CT of the chest
Which of the following is NOT a predisposing factor for COPD? Low socio-economic status Deficiency in alpha-1 antitrypsin Low birth weight Diabetes Poor nutrition
DM
Which of the following is an indicator of a severe acute asthma exacerbation? Decrease in vital capacity Decrease in PEFR Decrease in residual volume Decrease in TLC Decrease in inspiratory reserve volume
Decrease in PEFR
Which of the following is the correct set of PFTs in asthma? Decreased FEV1/FVC, decreased TLC, increased RV Decreased FEV1/FVC, increased TLC, normal RV Decreased FEV1/FVC, increased TLC, decreased RV Increased FEV1/FVC, decreased TLC, decreased RV Decreased FEV1/FVC, increased TLC, increased RV
Decreased FEV1/FVC, increased TLC, increased RV
Which of the following is not true about asthma? Associated with allergy. Decreased prevalence in inner cities. Eczema is associated with extrinsic asthma. Non-allergic asthma presents later in life. Associated with obesity.
Decreased prevalence in inner cities.
Which of the following is NOT a feature of lung function in an emphysematous patient? On expiration, there is dynamic airway collapse Low transfer factor There is a dip in the expiratory curve on the flow volume loop Increased total lung volume Decreased residual volume
Decreased residual volume
Which of the following is not seen in the pathogenesis of asthma? Increased mucus production Decreased smooth muscle tone Increased inflammation Increased edema Increased smooth muscle tone
Decreased smooth muscle tone
A conscious, well-oriented patient with COPD has an acute exacerbation that is rapidly worsening. To help support her breathing, the decision to preemptively intubate is made. When this is explained to the patient she explains that she has "do not resuscitate" as part of her advanced directives. What is the next step of management? Ask her husband to give permission to intubate Perform an intubation as the patient is incapable of making medical decisions at this time Ask her health power of attorney to consider the decision for intubation Do not intubate
Don't do it
Which of the following signs are absent in a "pink puffer" COPD patient who is NOT in respiratory failure? Pursed lips breathing Use of accessory muscles Edema High respiratory rate Cachexia
Edema
Which of the following is most important in the diagnosis of asthma? Chest x-ray History Carotid ultrasound Chest ultrasound Chest CT
History
Which of the following is true about emphysema? Airspace walls are usually not affected in emphysema. The primary feature of emphysema is fibrosis. DLCO is unchanged in emphysema. Emphysema is characterized by abnormal and permanent enlargement of the airspace distal to the terminal bronchiole. Emphysema is characterized by a reversible enlargement of the airspace.
Emphysema is characterized by abnormal and permanent enlargement of the airspace distal to the terminal bronchiole.
What is the most common type of asthma? Obesity-associated asthma Intrinsic asthma Exercise-induced asthma Anaphylactic asthma Extrinsic asthma
Extrinsic asthma
Which of the following is NOT a common cause of small airway obstruction? Foreign body obstruction in the bronchi Allergic bronchopulmonary aspergillosis Autoimmune obliterative bronchiolitis Hypersensitivity pneumonitis Chronic asthma
FBO
Which of the following pulmonary function test findings are seen in emphysema? FVC > 80% FEV1/FVC = 80% FEV1/FVC < 80% FEV1 > 80% FEV1/FVC > 80%
FEV1/FVC < 80%
Which of the following best explains pulsus paradoxus? Fall in diastolic blood pressure during inspiration Rise in systolic blood pressure during inspiration Fall in diastolic blood pressure during expiration Fall in systolic blood pressure during expiration Fall in systolic blood pressure during inspiration
Fall in systolic blood pressure during inspiration
Which of the following is NOT a part of the pathogenesis of COPD? Fibrosis of the lung Inflammation of bronchioles Bronchial obstruction Mucus hypersecretion Alveolar destruction and dynamic airway disease
Fibrosis of the lung
Which of the following statements is correct regarding acute exacerbations of COPD? Acute exacerbations are only caused by bacterial infections Acute exacerbations do NOT vary in severity Acute exacerbations always require aggressive treatment First line treatment includes muscarinic antagonists and antibiotics Acute exacerbations occur at regular periodic intervals
First line treatment includes muscarinic antagonists and antibiotics
Vocal cord dysfunction is most often seen in which of the following groups? Coal workers Navy workers Healthcare workers Roofers Painters
Healthcare workers
Which of the following is not a finding in the diagnostic workup of asthma? Decrease in FEV1/FVC. A decrease in FEV1 after the administration of methacholine. Increase in FEV1/FVC. Increase in TLC. Increase in RV.
Increase in FEV1/FVC.
Which of the following arterial blood gas changes is a marker for severe disease in a patient with an acute asthma attack? Increase in PaO2 Decrease in PaCO2 Increase in PaCO2 Decrease in PaO2
Increase in PaCO2
Which of the following is NOT a feature of severe asthma? Respiratory rate of over 25 breaths per minute Heart rate of over 110 per minute Increase in the peak expiratory flow rate compared to values recorded when not sick Pulsus paradoxus Inability to speak in full sentences
Increase in the peak expiratory flow rate compared to values recorded when not sick
Which of the following is NOT a common principle of airway obstruction in COPD? Patients with COPD can become easily symptomatic due to prematurity and low socioeconomic status Inhalation of cigarette smoke causes an increase in the rate of decline of FEV1 Inhalation of cigarette smoke causes an increase in FEV1 Patients with COPD can become more symptomatic when there is poor lung development Inhalation of cigarette smoke causes increases in the loss of FEV1 to about 100 ml/ year
Inhalation of cigarette smoke causes an increase in FEV1
Which of the following is true about the mechanism of action of theophylline? Inhibits phosphodiesterase and increases cyclic AMP Inhibits phosphodiesterase and decreases cyclic AMP Stimulates phosphodiesterase and decreases cyclic AMP Inhibits phosphodiesterase and does not change cyclic AMP levels. Stimulates phosphodiesterase and increases cyclic AMP
Inhibits phosphodiesterase and increases cyclic AMP
Which of the following is NOT an example of an accessory muscle of respiration? Intercostalis externus Part of the serratus anterior Sternocleidomastoid Pectoralis minor Scalene
Intercostalis externus
A 60-year-old man who has never smoked presents with a moderately severe obstructive defect on spirometry and a normal transfer factor. Which of the following diagnoses is unlikely to cause these lung function changes? Chronic asthma Allergic bronchopulmonary aspergillosis Interstitial lung disease Bronchiectasis
Interstitial lung disease
Which of the following is not a risk factor for bronchiectasis? Interstitial lung disease COPD Immunodeficiency Cystic fibrosis Staphylococcal pneumonia
Interstitial lung disease
Which of the following statements is false? Extrinsic asthma is associated with allergies. Eczema is most commonly seen in extrinsic asthma. Intrinsic asthma is commonly seen in obesity. Intrinsic asthma is commonly seen in anorexia nervosa. Non-allergic asthma presents later in life.
Intrinsic asthma is commonly seen in anorexia nervosa.
Which of the following statements is NOT true regarding invasive ventilation? Intubation is not suitable for drowsy or agitated patients Intubation is less appropriate for severely disabled patients Intubation is appropriate in a COPD patient with a clearly reversible cause of exacerbation Intubation requires muscle paralysis and a mechanical ventilator It can be difficult to wean severe COPD patients off the ventilator
Intubation is not suitable for drowsy or agitated patients
Which of the following is false regarding centrilobular emphysema? The release of proteolytic enzymes destroys the alveoli. Coal workers' pneumoconiosis is a risk factor. It leads to air trapping. It is associated with the destruction of the trachea. Cigarette smoking is a risk factor.
It is associated with the destruction of the trachea.
Why does a patient with emphysema purse their lips during exhalation? It provides resistance, allowing an increase in pressure at the alveoli to prevent its collapse. It prevents the progression of the disease. It provides more oxygen to the lung. It helps the exchange of gases in the alveoli. It helps maintain the respiratory drive.
It provides resistance, allowing an increase in pressure at the alveoli to prevent its collapse.
Which of the following statements is correct about the hygiene hypothesis? Lack of exposure to antigens early on in life decreases the risk of developing asthma-like symptoms in later life. Lack of exposure to antigens early on in life leads to an increased susceptibility to develop asthma-like symptoms in later life. Lack of exposure to antibodies early on in life leads to an increased susceptibility to develop asthma-like symptoms in later life. Lack of exposure to antigens early on in life leads to an increased susceptibility to develop carcinoma in later life. Exposure to antigens early on in life leads to an increased susceptibility to develop asthma-like symptoms in later life.
Lack of exposure to antigens early on in life leads to an increased susceptibility to develop asthma-like symptoms in later life.
Which of the following inhalers is a common treatment for patients with severe COPD? None of the combinations Short-acting beta agonist with short-acting antimuscarinic Long-acting beta agonist with long-acting antimuscarinic Short-acting beta agonist with long-acting antimuscarinic Long-acting beta agonist with short-acting antimuscarinic
Long-acting beta agonist with long-acting antimuscarinic
Which of the following is not true regarding the pathological changes that occur in bronchiectasis? Bronchial wall destruction Cilia loss Lung hepatization Increased mucus production Decreased lumen size
Lung hepatization Hepatization is conversion into a substance resembling the liver; a state of the lungs when gorged with effuse matter
Which of the following is NOT a sign of an acute respiratory exacerbation in a 60-year-old male with COPD? Respiratory rate of 30 breaths per minute Pursed lip breathing Mild cyanosis of the lips Use of accessory muscles of respiration Excessive abdominal movement on respiration
Mild cyanosis of the lips
Which of the following symptoms are associated with type 2 respiratory failure? Cough Hemoptysis Morning headaches and drowsiness Chest pain Fatigue
Morning headaches and drowsiness
Which of the following is knocked out by theophylline? Myosin light chain kinase Phosphorylase Myosin heavy chain kinase Phospholipase A2 Phospholipase D
Myosin light chain kinase
Which of the following is the drug of choice in the management of mild intermittent asthma? Nebulized salmeterol Oral albuterol Inhaled steroid Nebulized albuterol Oral salmeterol
Nebulized albuterol
Which of the following cells produce elastase? Macrophages Clara type 2 pneumocytes Lymphocytes Clara type 1 pneumocytes Neutrophils
Neutrophils
Which one of the following cells is responsible for secretion of trypsin that is neutralized by alpha-1 antitrypsin? Basophils Neutrophils Monocytes Lymphocytes Eosinophils
Neutrophils
Which of the following is FALSE about non-invasive ventilation use in COPD? Noninvasive ventilation is not suitable for drowsy and agitated patients Noninvasive ventilation reduces the need for mechanical ventilation and intubation Non-invasive ventilation is useful in patients with a high respiratory rate Noninvasive ventilation is administered by non-rebreather mask or full face mask Non-invasive ventilation gives positive pressure with each breath and small positive end expiratory pressure
Non-invasive ventilation is useful in patients with a high respiratory rate
Which of the following is the correct representation of the flow volume loop in asthma? Obstructive loop, shift to the left Restrictive loop, shift to the right Restrictive loop, shift to the left Obstructive loop, bilateral shift Obstructive loop, shift to the right
Obstructive loop, shift to the left
What happens to the oxygen and carbon dioxide dissociation curve during hyperventilation in a patient with emphysema? Oxygen dissociation curve rises and reaches a plateau as it moves to the left. Carbon dioxide curve is a linear curve that points downward as it moves to the left. Oxygen dissociation curve rises and reaches a plateau as it moves to the right. Carbon dioxide dissociation curve moves downward and right. Oxygen dissociation curve rises and reaches a plateau as it moves to the right. Carbon dioxide dissociation curve moves upwards and right. Oxygen dissociation curve falls and reaches a plateau as it moves to the right. Carbon dioxide dissociation curve moves downwards and right. Carbon dioxide dissociation curve rises and reaches a plateau as it moves to the right. Oxygen dissociation curve is a linear curve that points downward as it moves to the right.
Oxygen dissociation curve rises and reaches a plateau as it moves to the right. Carbon dioxide dissociation curve moves downward and right.
Which of the following is represented on the x-axis on the oxygen and carbon dioxide dissociation curve? pCO2 Oxygen saturation pO2 Venous CO2 Venous O2
PO2
Which of the following parameters is NOT altered significantly during an exacerbation of COPD due to emphysema? All to the options do not alter in an episode of acute exacerbation of COPD due to emphysema FVC FEV1 Ratio of FEV1/FVC Peak expiratory flow
Peak EF
Which of the following provides the correct definition of emphysema? Permanent enlargement of the airspace distal to the bronchi Temporary enlargement of the airspace distal to the terminal bronchioles Permanent enlargement of the airspace proximal to the terminal bronchioles Temporary enlargement of the airspace proximal to the terminal bronchioles Permanent enlargement of the airspace distal to the terminal bronchioles
Permanent enlargement of the airspace distal to the terminal bronchioles
Which of the following clinical symptoms is unusual in patients with severe COPD? Depression and anxiety Pleuritic chest pain Weight loss Ankle edema
Pleuritic chest pain
Which of the following should be considered in the differential workup of asthma? Post-nasal drip and GERD Gilbert's syndrome Post-streptococcal glomerulonephritis Pneumococcal agent Gastroparesis
Post-nasal drip and GERD
Which of the following is NOT a factor in deciding whether mechanical ventilation of a COPD patient is indicated? Presence of co-morbidities like pneumonia The level of disability of the patient The frequency of exacerbations Previous ventilation episodes The patients choice for intubation
Presence of co-morbidities like pneumonia
Which of the following features are absent in a COPD patient referred to as a "blue bloater" who is not in respiratory failure? Pursed lip breathing Edema Cyanosis Low respiratory rate Elevated weight
Pursed lip breathing
A 45-year-old man presents to your office with an FEV1/FVC ratio of 55% and a PO2 of 70 mmHg. On physical examination, a barrel-shaped chest is seen. Auscultation reveals rhonchi and rales. Which of the following maneuvers would most likely prevent the collapse of his alveoli? Opening the windows to breathe in the fresh air Coughing up sputum Pursing the lips during expiration. Sleeping with 3 pillows under the head Breathing into a plastic bag
Pursed lips
A patient diagnosed with COPD presents with dyspnea, intermittent hemoptysis, chronic cough with purulent thick green colored sputum, and a mild fever. He complains of easy fatigability and decreased exercise tolerance. Which portion of his presentation is suggestive of a bacterial infection? Mild fever Exercise intolerance Hemoptysis Purulent sputum Dyspnea
Purulent sputum
Which of the following symptoms can indicate that a patient with COPD is progressing to cor pulmonale, indicating severe disease? Raised JVP Severe cough Wheeze Musculoskeletal pain Purulent sputum
Raised JVP
What are the criteria for use of long-term oxygen therapy? Resting oxygen saturation less than or equal to 90% Resting oxygen saturation less than or equal to 92% Resting oxygen saturation less than or equal to 88% Arterial blood gas pH < 7.2 PaO2 < 75 mm Hg
Resting oxygen saturation less than or equal to 88%
What causes minimal V/Q mismatch in emphysema? Dilatation of the acinus Compression of the acinus Septal loss Rupture of the acinus Decreased recoil
Septal loss
A patient with COPD has FEV1 of 1 L and FVC of 3L. Expected values of FEV1 and FVC are 3 liters and 5 liters respectively. According to this spirometric assessment, what is the severity of the COPD? Moderate COPD FEV1 and FVC do not determine the severity of COPD No COPD Severe COPD Mild COPD
Severe
Which of the following is not true about aspergillus bronchopulmonary asthma? Spirometry diagnostic Infectious CXR/CT diagnostic Aspergillus fumigatus most common etiology High Aspergillus specific IgE
Spirometry diagnostic
Which of the following is NOT a treatment for chronic respiratory failure in COPD? Diuretics for cor-pulmonale Corticosteroids Long-term oxygen therapy Pulmonary vasodilators for cor-pulmonale Long term overnight non-invasive ventilation therapy
Steroids
Which of the following is a NOT a common clinical sign or symptom of an acute asthma exacerbation? Inspiratory stridor Cough Dyspnea Chest tightness Polyphonic expiratory wheeze
Stridor
Which of the following complications is responsible for the pneumothorax in a patient with COPD? None of the options Infections Hyperinflated lungs Expanded intercostal spaces Subpleural bullae
Subpleural bullae
Which of the following describes a "tracheal tug"? The cricoid cartilage moves downward towards the sternum on inspiration The pharynx moves down on expiration The trachea moves up on expiration The thyroid moves downward towards the sternum on expiration The mandible moves down on inspiration
The cricoid cartilage moves downward towards the sternum on inspiration
What is the reason for the decrease in the diffusion capacity of the lungs for carbon monoxide? There is increased fibrosis leading to decreased diffusion of carbon monoxide. The decreased surface area due to alveolar septal destruction leads to a decrease in the diffusion of carbon monoxide. There is decreased air entry leading to a lesser diffusion of carbon monoxide. There is decreased compliance leading to a lesser diffusion of carbon monoxide. There is increased obstruction leading to a lesser diffusion of carbon monoxide.
The decreased surface area due to alveolar septal destruction leads to a decrease in the diffusion of carbon monoxide.
Which of the following is the most appropriate statement regarding bronchiectasis? This is secondary to the impaired clearance of the interstitium that causes a vicious cycle of infection, inflammation, and obstruction. This is secondary to the impaired clearance of the airways that causes a vicious cycle of metastatic inflammation. This is primary to the impaired clearance of the airways that causes a vicious cycle of infection, inflammation, and obstruction. This is secondary to the impaired clearance of the pulmonary vasculature that causes a vicious cycle of infection, inflammation, and obstruction. This is secondary to the impaired clearance of the airways that causes a vicious cycle of infection, inflammation, and obstruction.
This is secondary to the impaired clearance of the airways that causes a vicious cycle of infection, inflammation, and obstruction.
What is the purpose of performing an echo-cardiogram periodically in a patient with COPD? To monitor for valvular defects To monitor for pulmonary hypertension To monitor for pneumopericardium To monitor for arrhythmia To monitor for structural heart changes like tubular heart
To monitor for pulmonary hypertension
Which of the following is responsible for the defense mechanism of pursed lip breathing in a patient with severe emphysema? To increase the peak expiratory flow in emphysema To decrease the residual volume in emphysema To increased total lung volume in emphysema To prevent dynamic airway obstruction in emphysema To prevent cyanosis in emphysema
To prevent dynamic airway obstruction in emphysema
Which of the following is a feature of bronchiectasis on the chest X-ray? Irregular hyperlucent shadows Cavitation Multiple cystic spaces Tram tracking Solid well-defined mass
Tram tracking
Presence of which of the following findings in a COPD patient is NOT an indication for surgical intervention? Type 2 respiratory failure Bullae Pneumothorax Lung volume reduction
Type 2 respiratory failure
Which of the following signs and symptoms is NOT always seen in patients with COPD due to emphysema? Prolonged expiratory phase Anterior to posterior diameter increase Muffled heart and lung sounds on auscultation Loss of dullness over the liver and heart on percussion Wheezing
Wheezing
Which of the following statements regarding the treatment of an acute COPD exacerbation is FALSE? Antibiotics are helpful in the treatment of exacerbation when infection is causing the exacerbation When oxygen is given through a mask, the target oxygen saturation is 98% and higher If blood gases of a patient show respiratory acidosis, then nasal ventilation is recommended Intravenous aminophylline is recommended in patients with severe exacerbation of COPD Systemic corticosteroids help reduce the duration of an exacerbation
When oxygen is given through a mask, the target oxygen saturation is 98% and higher
Which of the following is a potential complication of emphysema? Cor bovium Coronary heart disease Cor pulmonale Boot shaped heart Cor triatum
cor pulmonale
Which of the following causes the emphysema of alpha-1 antitrypsin deficiency to develop earlier? Air pollution Asbestos Mercury Smoking Alcohol
smoking
hich of the following is the primary treatment for COPD? Stop smoking Use of inhaled corticosteroids Use of short acting beta-2 agonists Use of oral mucolytics Use of antimuscarinic agents
stop smoking
