Asthma and COPD By Alaina darby

Which of the following is an anti-inflammatory drug? Omalizumab Montelukast Salmeterol Epinephrine a

Which of the following acts on mast cells? Budesonide Fluticasone Cromolyn Montelukast c

What is the purpose of methacholine? Muscarinic antagonist used to test for asthma Muscarinic agonist used to test for asthma Muscarinic antagonist used to treat asthma Muscarinic agonist used to treat asthma b

Which of the following is not a trigger for asthma? Environmental exposure Food and additives Diseases Warm air d

Which is true about the development of asthma? Its progression is primarily determined by genetics Viral infection during infancy increases incidence of asthma Environmental factors are most influential after immune development It may further develop into allergies b

Which of the following is true of asthma attack? Bronchospasm occurs late in the attack Inflammation is mediated by histamine release by mast cells Inflammation is a delayed response Bronchospasm is mediated by cytokine signaling c

Which of the following is true of the progression of asthma? Bronchospasm directly causes mucus hypersecretion through smooth muscle constriction Tissue edema and shedding of the surface epithelium is due to chronic inflammation Chronic inflammation causes remodeling of pulmonary tissue Bronchospasm is caused by the activation of adrenergic nerves c

Which of the following is true of bronchoconstriction? Non-asthmatics experience no bronchoconstriction at normal methacholine doses Hypersensitivity is an exaggerated response to normal stimulus dose Hyperreactivity is an exaggerated response to a high stimulus dose A positive reaction is considered to be a 20% rise in FEV1 c

They no longer use CFC’s as a propellant Which of following is a reason that asthma inhalers are so expensive in the US? They no longer use CFC’s as a propellant They are no longer under patent They have a longer than usual patent They are fairly recent medications a

Which of the following is described by daily inhaler use, two nighttime attacks per week, and a PEF of 75%? Intermittent Severe Mild persistent Moderate persistent d

Which of the following does not promote bronchodilation? Adenosine Theophylline Muscarinic antagonists cAMP a

What is the mechanism of methylxanthines? Phosphodiesterase analog Promote adenosine Inhibit conversion of cAMP to AMP Binding adenosine directly c

Which of the following is true? Muscarinic receptors are found in the large bronchioles, beta 2 receptors are found in the small bronchioles Muscarinic receptors are found in the large bronchioles, beta 2 receptors are found in the large bronchioles Muscarinic receptors are found in the small bronchioles, beta 2 receptors are found in the large bronchioles Muscarinic receptors are found in the small bronchioles, beta 2 receptors are found in the small bronchioles a

M1 is found in the bronchioles M2 is found in the submucosal glands Which of the following is true of the location of muscarinic receptors? M1 is found in the bronchioles M2 is found in the submucosal glands M2 is found in the autonomic ganglia M3 is found in the submucosal glands d

Which is not a benefit of using tiotropium over ipratropium? It has a shorter onset of action It has a longer duration of action It is selective for M1 and M3, preventing endogenous Ach release It has greater muscarinic receptor affinity a

Those with bleeding risk Those with BPH Those with kidney failure Which group of individuals should be cautioned about using ipratropium? Those with cancer Those with bleeding risk Those with BPH Those with kidney failure c

Saquinavir and diruetics can prolong the effects Which of the following is true about drug interactions with beta 2 agonists? Saquinavir and diruetics can prolong the effects Beta blockers are physiological opposites MAOIs and TCAs exacerbate hypokalemia Beta blockers can prevent acute bronchospasm treatment d

Which of the following is a “reliever”? Salmeterol Albuterol Formoterol Indacaterol b

Which of the following is a therapeutic action of albuterol? Stabilize mast cells Contract smooth muscle Block beta receptors Reverse hypokalemia a

Why are glucocorticoids often used in combination with beta agonists? They cause additional bronchodilation They can also bind to and block the M3 receptors They cause upregulation of beta receptors They enhance delivery of the beta agonist to its site of action c

Prolonged use has led to uncoupling from the receptor Beta agonists do not work well as bronchodilators in some patients, which of the following is not a reason for this? Prolonged use has led to uncoupling from the receptor Binding of beta-arrestin has led to internalization of the receptors Some patient exhibit SNPs causing diminished activity of the receptor Prolonged use has let to damage in the DNA encoding the receptor d

Which of the following does not stabilize mast cells? Albuterol Theophylline Cromolyn sodium Obuzamab b

Which of the following is a reason continued use of LABAs? They cause glucocorticoid receptor upregulation They enhance the effects of glucocorticoids Bronchoconstriction causes tissue remodeling Inflammation can often be prevented by LABA’s c

SABAs cause bronchodilation but anticholinergics do not Which of the following is a reason for combining SABAs and anticholinergics? SABAs cause bronchodilation but anticholinergics do not Their receptors are located in different parts of the bronchioles They cause synergistic effects when given together They are not effective on their own b

Which of the following is not a potential anti-inflammatory target? Nucleus of cytokine producing cells The antibodies themselves The target cell Cytokines themselves b

Which of the following act directly on the cytokines? Cytokine synthesis inhibitors Signal transduction inhibitors Monoclonal antibodies Receptor antagonists c

How do methylxanthines enhance the effects of beta-2 activation? Maintenance of cAMP levels Inhibition of adenosine action Upregulation of beta-2 receptors Enhanced cAMP synthesis a

Which of the following is not true of cromolyn sodium? It stabilizes mast cells It produces systemic side-effects It has no bronchodilator activity It is only for prophylactic use b

Which of the following is an inhaled steroid? Methylprednisone Beclomethasone dipropionate Prednisolone c

Occupancy of importin alpha Increased mucus secretion Which of the following is not a mechanism through which corticosteroids produce their effects? Occupancy of importin alpha Increased mucus secretion Repression of transcription factors Increased anti-inflammatory lipocortins b

Which of the following produce most of corticosteroid side effects? Trans activation Lipocortins Inflammatory proteins GATA-3 a

Which of the following is true of asthma? Neutrophilic asthma is steroid sensitive Neutrophilic asthma leads to severe asthma Eosinophilic asthma is steroid resistant Eosinophilic asthma leads to severe asthma b

Changes in binding affinity Which of the following would not be a reason for the ineffectiveness of steroids in COPD? Changes in binding affinity Overexpression of the other form of glucocorticoid receptor Decreased cytokine signaling Downregulation of histone deacetylase 2 c

Deliver it directly to the site of action Which of the following is the primary reason for inhaling corticosteroids rather than taking them orally? Deliver it directly to the site of action Prevent oropharyngeal candidiasis Prevent systemic effects Avoid first pass metabolism c

Controlled particle size Which of the following would not be a beneficial attribute when developing a steroid? Inactive prodrugs Reduced excretion Dissociated drugs Controlled particle size b

Which of the following is true of the synergism of beta-2 agonists and their effects on corticosteroids? They stimulate Gs They stimulate Gq They stimulate Gi They stimulate Gt a

Which of the following is not a routine test that is necessary for someone taking a combined corticosteroid/LABA? Blood glucose Serum potassium Pulmonary function Liver function d

Which of the following pairs is responsible for leukotriene synthesis? COX1/ COX2 Phospholipase A2/ thromboxane 5 lipoxygenase/ C4 synthetase 5 lipoxygenase/ thromboxane c

Target leukotriene formation as an alternative therapy Which of the following would be a method of treating an individual who is unresponsive to corticosteroids who is experiencing inflammation and bronchospasm? Target leukotriene formation as an alternative therapy Add beta agonists to enhance corticosteroid response Target cyclooxygenase enzyme as an alternative therapy Target the neutrophils and eosinophils that mediate the asthmatic response a

Which is not an indication for members of the “kast” family? Asthma Exercise-induced bronchospasm COPD Allergic rhinitis c

Which of the following is true of the “kast” family? They all inhibit CYP2C9 and CYP3A4 They cause frequent side effects They are a bronchodilator They can be given by mouth d

Which of the following would not be an advantage of antileukotrienes? Greater symptom improvement in severe asthma Better adherence Beneficial benefits in neuronal regulation When a beta-2 agonist is contraindicated c

Which of the following is a leukotriene synthesis blocker? Montelukast Zileuton Theophylline Omalizumab b

Which of the following can cause anaphylaxis and is therefore only administered in a clinical setting? Montelukast Zileuton Theophylline Omalizumab d

Which of the following treatment regimens is the first choice of treatment for intermittent asthma? SABA LABA ICS Cromolyn a

Which of the following is not a treatment for acute asthma? Norepinephrine Short-acting anticholinergics Systemic or inhaled steroids MgSO4 a

Which of the following are the common forms of COPD? Asthma and emphysema Pneumonia and bronchitis Bronchitis and emphysema Asthma and pneumonia c

Which of the following is true of the profile for COPD? Younger (children) Progressive dyspnea Good response to corticosteroids Airflow normalizes after episode b

Which of the following is a drug that is labeled for smoking cessation? Varenicline Clonidine Mecamylamin Naltrexone a

Which of the following is true of nicotine addiction? Cigarette smoke only binds to nicotinic receptors in the VTA Nicotine initially signals the dopaminergic pathway The dopaminergic pathway is quickly desensitized Dopamine signaling gives rise to the withdrawal symptoms d

Attaining of high levels of nicotine to mimic cigarette response Which of the following is the mechanism for nicotine replacement therapy? Attaining of high levels of nicotine to mimic cigarette response Produce sustained plasma nicotine level that is tapered Quick accumulation of peak levels Induction of the GABA response b

Which of the following is true of Varenicline? Agonist of the α4β2 nicotinic receptor Causes the release of mesolimbic dopamine Is solely responsible for depressive effects One of the most effective single drugs b

Which of the following is true of Buproprion? More effective than varenicline Less effective than nicotine replacement May cause sedation and depression Is a norepinephrine and dopamine reuptake inhibitor d

Which of the following can be used in conjunction with methylxantines to loosen phlegm and bronchiole secretions? Theophylline Guaifenesin Varenicline Roflumilast b

Which of the following is used only for individuals with severe disease symptoms, reduces the requirement for corticosteroids, and inhibits the PDE enzyme? Theophylline Guaifenesin Varenicline Roflumilast d

Which of the following would not be contraindicated in COPD? Sedatives Beta-blockers Glucocorticoids Aspirin ACE-inhibitors c