Obstructive Lung Disease, Chapter 25 Egan's
Spirometry
An asthma patient's best effort produces a PEFR of 55% of personal best. What is indicated at this time?
Chronic productive cough
Which complaint is most closely associated with the diagnosis of chronic bronchitis?
Cigarette smoking
Which factor is associated with a decrease in the plasma levels of theophylline in an asthmatic patient?
Breo Ellipta
Which medication is a once-daily combination of a beta-2 agonist and an inhaled corticosteroid?
1. Airway inflammation 2. Partially reversible airway obstruction 3. Progressive airway obstruction
Which of the following are typically found in a patient with COPD?
Cromalyn
Which of the following asthma medications is not typically administered during pregnancy?
Ipratropium bromide
Which of the following asthma medications is not typically administered during pregnancy?
Toluene diisocyanate
Which of the following has been identified as the most common cause of occupational asthma?
Methylxanthines
Which of the following medications is generally only used if the patient still has debilitating symptoms from stable COPD, despite inhaled bronchodilator therapy?
Beta-2 agonists
Which of the following medications is indicated for regular use in patients with stable COPD?
Expense
Which of the following problems is associated with intravenous augmentation of synthetic alpha1-antitrypsin for the patient with genetic emphysema?
1. Improved exercise endurance 3. Improved quality-of-life 4. Improved survival
Which of the following pulmonary function improvements have been associated with lung volume-reduction surgery (LVRS) in patients with emphysema?
Oral candidiasis
Which of the following side effects is associated with the use of inhaled corticosteroids?
Accessory muscle usage
Which of the following signs associated with COPD is considered a late manifestation?
1. The prevalence has increased significantly over the past 20 years in the United States.
Which of the following statements are true about the incidence of asthma?
2. Permissive hypercapnia 4. Small tidal volumes.
Which of the following strategies is useful in the mechanical ventilation of a patient in status asthmaticus?
Chest pain
Which of the following symptoms is not a typical symptom of asthma?
Spirometry
Which of the following tests is recommended as part of the initial assessment of asthma?
continue current therapy.
You are called to the ER to assess a 25-year-old female patient in status asthmaticus. Her PEFR results of pre- and post-bronchodilator therapy are given below: You are called to the ER to assess a 25-year-old female patient in status asthmaticus. Her PEFR results of pre- and post-bronchodilator therapy are given below: 1st attempt 216 pre 334 post 2nd attempt 224 pre 330 post 3rd attempt 210 pre 340 post You should suggest to the ER physician to:
It accelerates recovery as noted in FEV1.
During an acute exacerbation of COPD, what is the role of IV methylprednisolone?
destruction of alveolar walls without fibrosis.
Emphysema is defined as:
200 ml
How much improvement is needed in the FEV1 after bronchodilator therapy before reversibility can be considered present in the patient with obstructive lung disease?
Cigarette smoking
What is the leading risk factor for the development of COPD?
COPD
What lung disease is the most common current indication for lung transplantation?
Chronic bronchitis
What medical problems are suggested by Mr. Jones' medical history?
corticosteroids
What medication is currently the most effective for the treatment of asthma?
Inflammation of the airways
What pathophysiologic characteristic of asthma has been most recently emphasized in the description and subsequent treatment of this disease?
2% to 3%
What percentage of all cases of COPD is caused by alpha1-antitrypsin deficiency?
Environmental control
What step must be taken to gain control of asthma in a patient that is experiencing frequent emergency department visits?
Bronchoprovocation testing with pulmonary function tests
What test is most useful for the diagnosis of asthma in the symptom-free patient?
Immunotherapy
What treatment strategy is most controversial for a patient with asthma?
Third
Where does COPD rank among the leading causes of death in the United States?
Small
Which airways are most susceptible to airway obstruction in patients with COPD?
severe
A patient is admitted to the emergency department with an acute asthma exacerbation. Based on the following blood gas results, how severe was the asthma attack? pH 7.35, PaO2 58 mm Hg, PaCO2 46 mm Hg, HCO3- 18 mEq/L, SaO2 89%
Noninvasive ventilation
A patient is experiencing an exacerbation of COPD. He is 65 years old, slim, and in notable distress with tachypnea, tachycardia, and an arterial blood pH of 7.29. Which of the following therapies would be most indicated?
Add or increase the dose of antiinflammatory.
According to the National Asthma Education Project guidelines, what should be considered if the patient with asthma requires more than 3 or 4 puffs of beta-2 agonists per day?
Patient should probably seek medical attention now
An asthma patient's best effort produces a PEFR of 55% of personal best. What is indicated at this time?
24 million
Approximately how many Americans are affected by COPD?
145,000
Approximately how many individuals died of COPD in the United States in 2008?
cystic bronchiectasis.
Bronchiectasis characterized by progressive, distal enlargement of the airways, resulting in sac-like dilatations is classified as:
Beta-2 agonists
Identify the drug whose regular use in the treatment of asthma may worsen control or even increase the risk of death by asthma.
Large amounts of purulent sputum
Identify the hallmark symptom of bronchiectasis.
Reversal of the FEV1 after use of a bronchodilator
It is not clear whether your patient has COPD or asthma. Which of the following characteristics is most closely associated with the diagnosis of asthma?
57 mg/dl
What is the critical alpha1-antitrypsin level below which lung elastin is attacked and broken down?
Swimming indoors
Of the following common causes of asthma, which is the least likely to cause exercise-induced asthma?
2. Inflammation and obstruction of small airway 3. Loss of elasticity 4. Active bronchospasm
The mechanisms of airway obstruction in COPD include which of the following?
$50 billion
What is the approximate cost of COPD to the U.S. health system?
Salmeterol
What beta-2 agonist is associated with 12 to 24 hr of bronchodilation?
Antigens attaching to IgE molecules on the mast cell surface.
What causes the degranulation of mast cells in asthma patients?
Peak expiratory flow
What does the National Asthma Education Project recommend be measured at home in patients with moderate to severe asthma?
Aspiration of gastric acid at night
What etiologic factor is associated with the onset of nocturnal asthma?