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?
3 | |
6 | |
7 | |
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
Non-response to antigen | |
Atopic response to Ag with sensitisation and effector stage | |
Most always absent family history | |
Often occurs following upper respiratory tract infection |
Question 3 |
Of the first interaction with an inhaled allergen in atopic asthma ...
APCs present to B cells | |
Mast cells degranulate when activated by IgG | |
Cytokines trigger an up regulation of SVR | |
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?
Chronic bronchitis | |
Emphysema | |
Asthma | |
Interstitial lung disease |
Question 5 |
Which of the following cell types is a marker of chronic bronchial mucosal inflammation?
Antigen presenting cells | |
T-helper cell | |
B lymphocyte | |
Eosinophil |
Question 6 |
A patient tests positive at threshold for FeNO. What does this represent?
URTI with presentation of a cell with basic staining granules | |
LRTI with presentation of a cell with basic staining granules | |
LRTI with presentation of a cell with neutral staining granules | |
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?
Mild | |
Moderate | |
Acute severe | |
Life threatening |
Question 8 |
In which asthmatic instance would you administer a beta-2 agonist IV?
You would not | |
First-line treatment | |
Extremis | |
For chronic prophylaxis |
Question 9 |
Which of the following is not true of acute exacerbation of asthma treatment?
High flow oxygen is first line | |
Hydrocortisone is given PO | |
Consider theophylline | |
Consider magnesium sulphate |
Question 10 |
Ipratriopium bromide
Is indicated for administration before hydrocortisone in acute exacerbation of asthma | |
Agonises M3R | |
Is a long-acting medication | |
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?
Salmeterol | |
ipratropium | |
Montelukast | |
Prednisolone |
Question 12 |
The following is a less common cause of COPD
URTI | |
Protease deficiency | |
Epithelial transition | |
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
Trachea | |
Laryngopharynx | |
Bronchioles | |
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?
Short of breath | |
Productive cough | |
Wheeze | |
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?Prednisolone for 7 days ± antibiotics | |
Prednisolone for 2 weeks | |
Antibiotics and fluticasone for 7 days | |
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?His IRV has fallen significantly | |
His FEV has fallen greater relative to the mean | |
His TV is symptomatically reduced | |
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?Smooth muscle cell contracture | |
Inflammatory cell chemotaxis | |
Dynamic hyperinflation | |
Reduced elasticity of the interstitium |
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There are 17 questions to complete.