As an affiliate, we receive compensation if you purchase through this link. In this section, we’ve provided several practice questions so that you can dive even deeper into this topic. most common severity of asthma seen in clinical practice. What will the Spirometry show for chronic obstructive pulmonary disease?There will be reductions in force expiratory volume in the first second (FEV1), strong predictor of mortality rate; FEV1/FVC (forced vital capacity) and mid-expiratory flow rate. Internal Medicine Board Review Flashcards - This eBook contains 50 Pulmonary Disease and Critical Care Flashcards. Find out how you can intelligently organize your Flashcards. 21. What are the advanced stages of chronic bronchitis?Larger airways plug, V/Q (ventilation/perfusion) mismatch, pulmonary arteries constrict and polycythemia, 27. Encourage advancement to 2nd Class. [, Rrt, Des Terry Jardins MEd, and Burton George Md Facp Fccp Faarc. How many times is a smoker more likely to die of chronic obstructive pulmonary disease than a non-smoker?10 times. Recently Added Questions The image shown below is a Wright-Giemsa stained bone marrow aspirate smear from a child who presented with a 5 cm abdominal mass. Zafirlukast is. PaO2<55% or SaO2 <88% on room air taken 2 times over 3 weeks period in stable patient and PaO2 55-60% if evidence of pulmonary hypertension (HTN), congestive heart failure (CHF), or polycythemia.. 23. Reflection: A board review will touch on many elements mentioned in previous questions. So here are 80 free pulmonary and critical care board review questions to help sharpen your brain to a test-slicing razor's edge. It is pertinent to establish a baseline in order to start treatment and follow-up to track the progression of this disease. What type of COPD has “quiet” breath sounds without adventitious sounds on auscultation?Emphysema. First of all, it is important to be familiar with the procedures and purposes of a Board of Review. 12. What are the COPD severity staging guidelines?The Global Initiative for Chronic Obstructive Lung Disease (GOLD) staging systems are: Stage 1 or Mild COPD, patients with FEV1 (forced expiratory volume in one second) <80% of predicted. montelukast is not an CYP inhibitor. According to the CDC, it’s the third leading cause of death in the United States. 18. Chronic bronchitis is an increase production of mucus from bronchi. What are three classes of medications used in asthma for their bronchodilating properties? Criteria for round-the clock treatment in COPD. Disclaimer. Pulmonary disease and critical care are an extremely important part of the Internal Medicine Medical Clerkship and ABIM Board exam. 67. We weren't able to detect the audio language on your flashcards. www.ncbi.nlm.nih.gov/pmc/articles/PMC4106574, www.ncbi.nlm.nih.gov/pmc/articles/PMC3657849, www.ncbi.nlm.nih.gov/pmc/articles/PMC4131503, www.ncbi.nlm.nih.gov/pmc/articles/PMC6545670, Obstructive Lung Diseases: COPD, Asthma, and Related Diseases, Amazing Tips for Surviving Respiratory Therapy School, Asthma Practice Questions for Respiratory Therapy Students, Bronchiectasis Practice Questions for Respiratory Therapy Students, Chronic Bronchitis Practice Questions for Respiratory Therapy Students, Avoid triggers and recurrent infections (such as the flu and pneumonia), Egan’s Fundamentals of Respiratory Care. Chronic Obstructive Pulmonary Disease(COPD) 4. 72. Who should undergo spirometry testing to detect chronic obstructive pulmonary disease?Smokers or ex-smokers 40 years of age and older who have the symptoms. Identify this brand name medication used in COPD maintenance: Advair HFA, Identify this brand name medication used in COPD maintenance: Symbacort, Identify this brand name medication used in COPD maintenance: Combivent, ipratropium bromide and albuterol (anticholinergic + SABA). True or False: COPD is reversible and tends to happens gradually. When can an advance directive become effective?When the patient’s condition is determined to be non-reversible with no hope of recovery, and the patient is no longer able to speak for her. 10. These early decisions about overal… What are available treatments for medical and respiratory of chronic bronchitis?Stop smoking to eliminate irritant. As a Respiratory Therapist or medical professional, it’s an important topic that you must be very familiar with. 2. The patient has a chronic productive cough with dyspnea on excretion. What are other ways to diagnose chronic obstructive pulmonary disease?Laboratory values, electrocardiogram (EKG), arterial blood gas (ABG) and chest x-ray (CXR). 24. Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Paul W. Jones, MD, PhD, is the global medical expert for the respiratory franchise at GSK. 10. Introducing Cram Folders! Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. What are the physical findings of chronic obstructive pulmonary disease?Barrel chest, cyanosis of mucosal membranes, increased resting respiratory rate, shallow breathing, and pursed lips during respiration. Find out how you can intelligently organize your Flashcards. Never disregard professional medical advice or delay in seeking it because of something you read in this article. What is the most common cause of chronic obstructive pulmonary disease?Smoking. Breath sounds and x-ray have no significant changes. The following are the general methods for treating a patient with COPD: This book provides a straightforward overview of Chronic Obstructive Pulmonary Disease. Which is more prevalent, asthma or COPD?Asthma is more prevalent but chronic obstructive pulmonary disease is more deadly. It can be used in asthma that is uncontrolled on optimized conventional therapy. What triggers exacerbation for chronic obstructive pulmonary disease?Infection, pollution, and cold weather. Patients suffering from chronic obstructive pulmonary disease relay more on the accessory muscle of the neck, shoulders and back to breathe rather than the diaphragm. When should a hospice referral be made for a COPD patient?When the disease enters Stage III-IV, 41. “Chronic Obstructive Pulmonary Disease.” PubMed Central (PMC), 1 Feb. 2013. Posteroanterior chest x-ray for Question 9. Initial round-the clock management of COPD: Indication to add ICS to initial COPD management: tiotropium, an anticholinergic inhaler used for COPD management. 48. Ipratropium bromide, when used in COPD provides which therapeutic effect: What is the pathophysiology of emphysema? What type of chronic obstructive pulmonary disease is common in a younger population (late 30s and 40s)?Chronic bronchitis. All patients with COPD are required to have an annual review to check their symptom control, inhaler technique, lung function, oxygen saturation if required, have a general medication and physical health check, offer help if smoking and review an individual care plan for what to do if become unwell. What is the main risk factor for chronic obstructive pulmonary disease?Smoking, 39. Use for at least 15 hours/day, NOT just in response to dyspnea. Coronavirus SARS-CoV-2 is currently causing a pandemic of COVID-19, with more than 3 million confirmed cases around the globe identified as of June 2020. Clinical Manifestations and Assessment of Respiratory Disease. Because of these findings, the nurse closely monitors the oxygen flow and the client’s respiratory status. What are some other causes of chronic obstructive pulmonary disease?Long term work environments that is smoky or dusty. Use SABA PRN. Is there evidence to support tapering PO CS dose after asthma flare? NEJM Knowledge+ Internal Medicine Board Review, Family Medicine Board Review, and Pediatrics Board Review are produced by NEJM Group, the organization behind the New England Journal of Medicine, NEJM Journal Watch, NEJM Catalyst, and NEJM Resident 360. What characteristic is in chronic obstructive pulmonary disease?This disease involves abnormal inflammation. Well, time is short. And here's a free pulmonary board review video from CMEinfo.com, a teaser for their pulmonary CME and pulmonary board review products: Subjects: ancc anp asthma boards copd fitzgerald np. What is the etiology of chronic obstructive pulmonary disease and lung damage risk factors?Smoking, genes, age and gender, lung growth and development, exposure to particles, social status and deficiency of serine protease inhibitor alpha 1 anti-trypsin (AAT). What will the arterial blood gas (ABG) show for patients diagnosed with early stages of chronic bronchitis?Arterial blood gas (ABG) will have a slight respiratory alkalosis with mild hypoxemia (↑PH, ↓PaCO2, ↓HCO3 ↓PaO2). 47. What are four diseases that are considered chronic obstructive pulmonary diseases?Emphysema, chronic bronchitis, refractory asthma and some forms of bronchiectasis. 30. why is montelukast superior to zafirlukast? AKA phopsphodiesterase inhibitor. What is the cornerstone of asthma therapy? What is a COPD Exacerbation? “Treatment of COPD: The Simplicity Is a Resolved Complexity.” PubMed Central (PMC), 5 Sept. 2020. Methods We analyzed data from 408,774 respondents aged 18 or older in the 2016 Behavioral Risk Factor Surveillance Syste… Mr. Smith, an 80-year old smoker, has stage II COPD. What are the criteria for home oxygen use?PaO2<55% or SaO2 <88% on room air taken 2 times over 3 weeks period in stable patient and PaO2 55-60% if evidence of pulmonary hypertension (HTN), congestive heart failure (CHF), or polycythemia. In well-controlled or intermittent asthma, PEF should be. 50. QUESTION 10–14. What is not a benefit of long-term oxygen therapy?Better absorption of medications and better mental functioning. Different preparations are NOT interchangeable mg to mg. Clinical uses of anticholinergics (ipratropium and tiotropium). What type of chronic obstructive pulmonary disease is referred as a “blue bloater”?Chronic bronchitis, 61. CBABE is a mnemonic that can be used as a simple way to learn and memorize all of the obstructive diseases. It is not from a specific disease. The following are the sources that were used while doing research for this article: Disclosure: The links to the textbooks are affiliate links which means, at no additional cost to you, we will earn a commission if you click through and make a purchase. BoardVitals Pulmonary and Critical Care Medicine CME Pro Plus offers more than 600+ peer-reviewed online case-style questions that will help you prepare for your board exams and stay up-to-date on relevant Pulmonary and Critical Care Medicine topics including Obstructive Lung Disease, Cardiovascular Disorders, and Gastrointestinal Disorders. 22. According to the ABIM exam blueprint, questions testing pulmonary disease topics comprises ~10% of the exam.That places it second only to cardiology’s 14% in terms of relative percentage. Medical Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 9. What are the general symptoms of COPD?Dyspnea, cough, sputum, fever, wheezing, chest tightness, and fatigue. What is the greatest risk of chronic obstructive pulmonary disease?Patients with COPD are at risk of a right-sided heart failure. This is the best choice for controller therapy and is needed for all but the mildest asthma. 8. Bronchial Asthma 3. 13. 57. [. Free, short podcasts with high yield board and shelf exam review. Systemic steroids can be administered by IV (intravenous), shot, or orally. It is a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible. Change in a patient's baseline dyspnea, cough and/or sputum beyond day-to-day variability sufficient to warrant a change in management. What is the progressive nature of chronic obstructive pulmonary disease and why is it important to establish a baseline and follow up?Chronic obstructive pulmonary disease will get worse over a progressive period of time. Dr. Jones’ primary research is focused on symptom measurement and cognitive outcome of COPD. What are the diagnostic test and result of chronic bronchitis?Chest x-ray (CXR) shows hyperinflation or air trapping, translucent or very dark, increased A-P diameter (barrel chest), flattened Diaphragm or blunted costophrenic angle, spider like projection in the bronchogram, and enlarged heart. The process may require some explanation on the part of the Board of Review Chairperson. What are criteria for well-controlled asthma or asthma that is intermittent and does not require controller therapy? What type of chronic obstructive pulmonary disease produces peripheral edema?Chronic bronchitis, 65. Please consult with your physician with any questions that you may have regarding a medical condition. Background Conventional measures to evaluate COPD may fail to capture systemic problems, particularly musculoskeletal weakness and cardiovascular disease. Why do the pulmonary vessels constrict during chronic bronchitis?Constriction happens because of hypoxemia leading to pulmonary vascular resistance (PVR). PLOS ONE; 13: 4, e0195055. Arthritis and COPD share many risk factors, such as tobacco use, asthma history, and age. What are the causes of chronic obstructive pulmonary disease?Chronic inflammatory responses, noxious particles and gases. What is the medical definition of COPD? 74. Cram.com makes it easy to get the grade you want! 46. 2. 73. What is the best ABX choice for a 52 year old man with an acute exacerbation of Stage II COPD? What are indications that antibiotic therapy may be needed in COPD flare? An adult male patient on ventilatory support has just been intubated with a 7.0 mm oral endotracheal tube equipped with a high residual volume low-pressure cuff. Printed review handout sheets on exam review topics. What are the pulmonary symptoms characteristic of COPD? Assess based on last 4 weeks. Respiratory TMC Review Practice Questions for the RRT Board Exam: 1. It is signed by two doctors. Pulmonary function testing shows decreased expiratory maneuver, forced vital capacity (FVC) of lung volume and capacity is increased along with ventricular tachycardia (Vt), right ventricle (RV), residual volume/total lung volume (RV/TLC) and functional residual capacity (FRC). Chronic Obstructive Pulmonary Disease(COPD) 4. Included topics in this practice quiz are: 1. 66. How much of an ICS dose is absorbed systemically? A patient is presenting with chronic obstructive pulmonary disease. Diseases of the Respiratory System 2. 38. What are the clinical manifestations of chronic bronchitis?Frequent cough with mucous expectorate, slight increase on respiratory rate (RR), and slight increase of heart rate (H), carbon dioxide (CO), blood pressure (BP), dyspnea only with lung infection. What does COPD stand for? 7. Is asthma a reason to limit physical activity? We'll notify you in the weekly email as we add new quizzes and board review questions in critical care and pulmonary medicine. 11. These board review questions and guide are created by PulmCCM contributors and are not eligible for ACCME / AMA PRA Category 1 Credit TM nor endorsed by any educational or professional entity. Such issues as the complexity of the performance problem, the size of the board, the stage of organisational life cycle and significant developments in the organisation’s competitive environment will determine the issues the board wishes to evaluate. How can you treat a patient with COPD? It is not from a specific disease. The more familiar terms ‘chronic bronchitis’ and ’emphysema’ are no longer used, but are now included within the COPD diagnosis. Clearly identified objectives enable the board to set specific goals for the evaluation and make decisions about the scope of the review. Because COPD causes wasting, weight gain resulting from smoking cessation is not much of a problem. According to GOLD COPD guidelines, what medication is indicated for stages I to IV? 36. 64. What are the differences on the major symptoms between chronic bronchitis and emphysema?In chronic bronchitis, symptoms consist of excessive sputum production for at least 3 months for a year and twice in a row while emphysema’s symptoms consist of the destruction of the gas exchange surfaces. Mosby, 2020. What is the most common test in diagnosing and monitoring chronic obstructive pulmonary disease (COPD)?Spirometry, 42. Not to be used as monotherapy. What heart problem is caused by chronic obstructive pulmonary disease?Cor pulmonale, 52. Dilate airway to help a cough with the use of bronchodilator that is sympathomimetic and administration of parasympatholytic agent like Beta 2-Parasympatholytic, xanthine, and theophylline that aids bronchial dilation. The Board of Review should try to gain a sense of how the Scout is fitting in to the Troop, and the Scout’s level of … So there you have it. What is the preferred long-term steroid administration route and why is it preferred?It is inhaled administration route because they don’t have the side effects of systemic steroids. Enlargement of airspaces distal to the terminal bronchiole. Add LABA and/or anticholniergic if needed. “Chronic Obstructive Pulmonary Disease: An Overview.” PubMed Central (PMC), 1 Sept. 2008. Next, we will discuss the treatment methods for COPD. A client with pneumonia is receiving supplemental oxygen, 2 L/min via nasal cannula. What are three classes of medications used in asthma for their anti-inflammatory properties? Bronchodilator. When is it appropriate to use systemic steroids?The appropriate use of systemic steroids is when nothing else works. 34. There is also a training module which you can use to educate your Committee members. Introduction More than 54 million US adults have arthritis, and more than 15 million US adults have chronic obstructive pulmonary disease (COPD). 23. What are non-pharmacologic measured to be encouraged in all patients with COPD: FEV1 is usually reduced as the disease progresses, but may be normal in early stages. What type of gastric problem is caused by long term corticosteroid use? Quickly memorize the terms, phrases and much more. Thereafter knowledge of an annual review will undoubtedly lead to more conscious governance and opportunities to introduce improvements (including replacement of board members). What are the potential complications of chronic obstructive pulmonary disease?Polycythemia (elevated RBC (red blood cell)), infection, atelectasis, pneumonia, pulmonary hypertension and respiratory insufficiency or failure. What is the breath sounds in advanced chronic bronchitis?Crackles with wet secretions wheezes that leads to bronchoconstriction (mucus plug) and Rhinflamedflammed airways. Use LEFT and RIGHT arrow keys to navigate between flashcards; Use UP and DOWN arrow keys to flip the card; audio not yet available for this language. Mindus S et al (2018) Asthma and COPD overlap (ACO) is related to a high burden of sleep disturbance and respiratory symptoms: results from the RHINE and Swedish GA2LEN surveys. Death is imminent. 22. Sometimes committee members struggle to come up with good Board of Review questions. Study Flashcards On ANCC Board Review: Asthma/COPD at Cram.com. Introducing Cram Folders! Indications for CXR in COPD exacerbation: Three most common bacterial agents in COPD exacerbation: Atypicals (M. and C. pneumo, legionella) are associated with what percentage of bacterial COPD flares? 1. What device must be surgically implanted?Transtracheal catheter, 55. Losartan 50 mg, HCTZ 12.5 mg, Amlodipine 5 mg daily, Tamsulosin (Flomax) 0.8 mg daily, Atorvastatin (Lipitor) 10 mg daily, Albuterol inhaler 2 puffs PRN for SOB, tiotropium (Spiriva) once daily We created detailed study guides for both Emphysema and Chronic Bronchitis, so definitely check those out if you’re interested. 70-85%, depending on age. 3. 20. What does FEV1 stand for?Forced Expiratory Volume in the first second. However, if the patient’s condition worsens, intubation and conventional mechanical ventilation would be indicated. Figure 44.1. Miravitlles M et al (2014) Generic utilities in chronic obstructive pulmonary disease patients stratified according to different staging systems. 14. What is the effect on airflow in terms of chronic obstructive pulmonary disease?Obstruction and/or limitation that is not completely reversible. Prevents the breakdown of cAMP (which causes bronchial relaxation) by phosphodiesterase. Best antibiotic choices for severe COPD flare: If a patient reports orthopnea as part of a pulm problem, what should you consider. Severity is based on most bothersome symptom. What is the best care approach suited for chronic obstructive pulmonary disease?Palliative care and home health, 43. Change in purulence or quantity of sputum. COPD NCLEX Questions. What may signal the existence of asthma?Bronchodilator reversibility, chronic bronchitis, and emphysema, 54. 32. 45. Pulmonary Medicine Board Review Questions. What are the three causes of chronic bronchitis?Smoking, recurring pulmonary infections as a child may increases susceptibility and air pollution, 25. 19. Ambulance attendance is often triggered by a respiratory infection. Cram has partnered with the National Tutoring Association. What are the available treatments for chronic obstructive pulmonary disease?Smoking cessation, oxygen therapy, pharmacological therapy, and pulmonary rehabilitation. Why is diaphragmatic breathing not usually recommended for patients with chronic obstructive pulmonary disease?Diaphragmatic breathing or deep breathing is done by contracting the diaphragm. So if you’re ready, let’s get started. Pneumonia That wraps up our study guide on COPD. These are all common questions from students enrolled in certain medical school programs. “CDC – Basics About COPD – Chronic Obstructive Pulmonary Disease (COPD).” Centers for Disease Control and Protection, 19 July 2019. You have created 2 folders. Characteristic timing of symptoms that suggests asthma: A worsening of asthma symptoms may be seen after: What is necessary to make the diagnosis of asthma: When is peak flow metering done re: asthma? To ensure adequate oxygenation of vital organs as evidenced by SpO2 of >=90% or PaO2 >=60 mmHg. 68. Patients experience shortness of breath when hurrying on the level or walking up a slight hill; Stage 2 or Moderate COPD, patients with FEV1=50-80% of predicted. 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