Obsrutive airway diseases are typified by inflammed, readily-collapsible bronchi (or more distal) structures with wheeze, shortness of breath and sometimes recurrent infections.  This is a quiz introducting some core concepts of asthma and COPD.  Good luck! 

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Clinical Aspects of Obstructive Airway Disease

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Question 1
What age is the most common onset of asthma?
A
3
B
6
C
7
D
2
Question 1 Explanation: 
3-5 year olds are the most likely age for asthma diagnosis - though it can occur at any age.
Question 2
Extrinsic asthma is best defined as
A
Non-response to antigen
B
Atopic response to Ag with sensitisation and effector stage
C
Most always absent family history
D
Often occurs following upper respiratory tract infection
Question 3
Of the first interaction with an inhaled allergen in atopic asthma ...
A
APCs present to B cells
B
Mast cells degranulate when activated by IgG
C
Cytokines trigger an up regulation of SVR
D
Th2 receive epitopic activation to trigger IgE release of B cells
Question 4
A 5 year old male present with acute SOB, non-productive cough and chest tightness. Which of the following is the most likely diagnosis on first-pass?
A
Chronic bronchitis
B
Emphysema
C
Asthma
D
Interstitial lung disease
Question 5
Which of the following cell types is a marker of chronic bronchial mucosal inflammation?
A
Antigen presenting cells
B
T-helper cell
C
B lymphocyte
D
Eosinophil
Question 6
A patient tests positive at threshold for FeNO. What does this represent?
A
URTI with presentation of a cell with basic staining granules
B
LRTI with presentation of a cell with basic staining granules
C
LRTI with presentation of a cell with neutral staining granules
D
URTI with presentation of a cell with orange staining granules
Question 7
A patient's peak flow has declined some 35%.  What form of reduction is this classified as?
A
Mild
B
Moderate
C
Acute severe
D
Life threatening
Question 8
In which asthmatic instance would you administer a beta-2 agonist IV?
A
You would not
B
First-line treatment
C
Extremis
D
For chronic prophylaxis
Question 9
Which of the following is not true of acute exacerbation of asthma treatment?
A
High flow oxygen is first line
B
Hydrocortisone is given PO
C
Consider theophylline
D
Consider magnesium sulphate
Question 10
Ipratriopium bromide
A
Is indicated for administration before hydrocortisone in acute exacerbation of asthma
B
Agonises M3R
C
Is a long-acting medication
D
Can exacerbate the cough of an asthmatic
Question 10 Explanation: 
A side effect of muscarinic blockade is dry mouth and reduced mucosal secretion, which can cause a non-productive cough.
Question 11
Which medication is not a useful treatment regimen for the smooth muscle dysfunction in acute exacerbation of asthma?
A
Salmeterol
B
ipratropium
C
Montelukast
D
Prednisolone
Question 12
The following is a less common cause of COPD
A
URTI
B
Protease deficiency
C
Epithelial transition
D
SIRS
Question 12 Explanation: 
Alpha-1-antitrypsin is a protease that degrades the neutrophilic exudates to protect the epithelium.
Question 13
Damage of emphysema is confined to
A
Trachea
B
Laryngopharynx
C
Bronchioles
D
Pulmonary acinus
Question 14

Stem 1 of 4

A 68 year old life-long smoker presents with shortness of breath that is all-present, a wheeze and constant productive cough with green-yellow expectorate.  He is regularly awakening at night with drenching sweats.
Which of the following represents a "constitutional symptom" of medical concern?
A
Short of breath
B
Productive cough
C
Wheeze
D
Night sweat
Question 15

Stem 2 of 4

The patient's acute exacerbation is brought under control. He is given a series of steroids. Which best indicated some portion of the desired prescription?
A
Prednisolone for 7 days ± antibiotics
B
Prednisolone for 2 weeks
C
Antibiotics and fluticasone for 7 days
D
Antibiotics and prednisolone for 10 days
Question 16

Stem 3 of 4

What has relevantly changed in the patient's peak flow recording, relative to the mean of his demography?
A
His IRV has fallen significantly
B
His FEV has fallen greater relative to the mean
C
His TV is symptomatically reduced
D
He has a reduced expiratory reserve volume owing to barreling of the thorax
Question 17

Stem 4 of 4

Which of the following is not a reversible cause of acute exacerbation of COPD in this patient?
A
Smooth muscle cell contracture
B
Inflammatory cell chemotaxis
C
Dynamic hyperinflation
D
Reduced elasticity of the interstitium
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