COPD By Alaina Darby

How long does it take after quitting for risk of coronary heart disease to decrease by 50%? 12 hours 2 weeks 6 months 1 year 5 years d

How long does it take after quitting to see improvement in lung function? 12 hours 2 weeks 6 months 1 year 5 years b

Which of the following leads to emphysema? Loss of cilia Goblet cell hyperplasia Elastin destruction Mucus plugging c

JR has been a smoker for 30 years and was recently diagnosed with COPD JR has been a smoker for 30 years and was recently diagnosed with COPD. Which of the following causes his pursed lip breathing? Airway inflammation due to increased mucus and protease activity Hyperinflation due to inspiratory muscle dysfunction Pulmonary hypertension due to ventilation/perfusion mismatch Decreased gas exchange due to increased airway resistance d

Which of the following is least likely to be seen in JR? Macrophages Eosinophils Neutrophils CD8+ T cells b

BD has smoked for 45 years. How often would you like to perform spirometry on this patient to screen for COPD? Every year Every 2 years Every 5 years Not until he has symptoms

For assessing JR, which of the following measures would you most likely use? RV TLC FVC FRC c

Which of the following would be diagnostic of COPD? FEV1/FVC < 70% FEV1/FVC < 80% FVC/FEV1 < 70% FVC/FEV1 < 80% a

Spirometry on TD found his FEV1/FVC to be 76% Spirometry on TD found his FEV1/FVC to be 76%. His FEV1 was 72% of predicted. What Gold class should he be placed into? I II III IV N/A e

Spirometry on SD found his FEV1/FVC to be 55% Spirometry on SD found his FEV1/FVC to be 55%. His FEV1 was 72% of predicted. What Gold class should he be placed into? I II III IV N/A b

Which of the following is properly matched to patient category? A: Gold III B: CAT 8 C: 3 exacerbations D: mMRC 1 c

Which of the following is not true of bronchodilators in COPD? Increase FEV1 Mortality benefit PRN or scheduled dosing Improve exercise performance b

Spirometry on AD found her FEV1/FVC to be 45% Spirometry on AD found her FEV1/FVC to be 45%. Her FEV1 was 62% of predicted. Her CAT score is 12. What medication(s) would be most appropriate? Albuterol Salmeterol Albuterol + Ipratropium Fluticasone + Salmeterol b

Which of the following causes bronchodilation through inhibition of phosphodiesterase and is a CNS stimulant? Albuterol Tiotropium Theophylline Roflumilast c

VR is a 55 y/o woman with no hospital or ER insurance who has recently been diagnosed with COPD. She was placed in Gold I, has no known exacerbations, and a CAT score of 14. Which of the following is likely MOST appropriate? Albuterol Salmeterol Ipratropium Fluticasone + Salmeterol c

SR is taking theophylline for her COPD SR is taking theophylline for her COPD. She has recently started having headaches, diarrhea, nausea, and dizziness. Which of the following medications may have recently be started? Phenytoin Fluvoxamine Roflumilast Carbamazapine b

Which of the following patients would benefit from roflumilast? Class A patient adherent to her albuterol Class B patient nonadherent to her salmeterol Class C patient adherent to her fluticasone/salmeterol Class D patient nonadherent to her mometasone/fomoterol + ipratropium c

Which of the following COPD patients should get the PPV-23? 60 y/o with FEV1 of 45% 70 y/o with FEV1 of 75% 50 y/o with FEV1 of 55% 45 y/o with FEV1 of 65% b

Which of the following has been shown to decrease mortality in COPD patients? Antibiotics LABA Oxygen LAMA ICS c

Which of the following would not be included in the assessment if HG was thought to be having a COPD exacerbation? Pulse oximetry Medical history EKG CBC BMP Spirometry CXR f

Which of the following is the initial treatment for a COPD exacerbation? Bronchodilator Corticosteroid Oxygen Antibiotics c

Which of the following would be a suitable oxygen saturation for a COPD patient undergoing an exacerbation? 86% 90% 94% 98% b

Which of the following is the preferred bronchodilator for COPD exacerbation? Theophylline Salmeterol Albuterol + ipratropium Albuterol + tiotropium c

JR was given albuterol + ipratropium JR was given albuterol + ipratropium. Which of the following symptoms is most likely due to the ipratropium component? Palpitations Tachycardia Nervousness Tremor a

What is not a reason that a corticosteroid should be given? Shorter LOS Better lung function Mortality benefit Reduced treatment failure c

Which of the following is the most appropriate dosing for corticosteroids? 30 mg prednisolone PO Q day x 7 days 1 mg budesonide nebulized Q day x 7 days 30 mg prednisolone PO Q day x 5 days 1 mg budesonide nebulized Q day x 5 days c

Which of the following antibiotics would be the LEAST appropriate therapy? Aminopenicillin Macrolide Fluroquinolone Tetracycline c

Which of the following patients would not be indicated for antibiotics? Increased dyspnea and sputum volume Increased sputum volume and purulence Increased dyspnea and sputum purulence Mechanical ventilation a

Which of the following would be a suitable duration of therapy for antibiotics? 4 days 7 days 14 days 21 days b

Which of the following would be a suitable duration of therapy for antibiotics and steroids? Antibiotics for 7 days and steroids for 7 days Antibiotics for 14 days and steroids for 7 days Antibiotics for 7 days and steroids for 5 days Antibiotics for 14 days and steroids for 5 days c