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NR601 MIDTERM QUESTIONS AND ANSWERS
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NR601 MIDTERM QUESTIONS AND ANSWERS
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NR601 MIDTERM QUESTIONS ANDANSWERS
Whatxarexthex3xprimaryxphysiologicalxchangesxofxaging?x-
x1.xReducedxphysiologicalxreservexofxmostxbodyxsystems,xesp.xcardiac,xresp,xrenal.
2.xReducedxhomeostaticxmechanismsxthatxfailxtoxadjustxregulatoryxsystemsx(i.e.xtempxcon
trol,xfluid/lytexbalance,xetc.).
3.xImpairedximmunologicalxfunctionx(infectionxriskxisxgreater,xautoimmunexdz'sxmorexprev
alent)
Whatxisxthexpreferredxamountxofxexercisexforxelderly?x-x30min/dayx5xdays/
wkxofxmoderatexexercise.
Ifxtryingxtoxlosexwt:x60min/day.
WhatxarexPFTs?x-
xGroupxofxtestsxthatxprovidexquantifiablexmeasurementxofxlungxfunction,xusedxtoxdxxrespxa
bnormalitiesxorxassessxprogression/resolutionxofxlungxdz.
WhatxisxFEV1?x-xForcedxExpiratoryxVolumexinx1xsecondx(80-120%)
WhatxisxFVC?x-xForcedxVitalxCapacityx(80-120%)
WhatxisxnormalxFEV1/FVCxratio?x-x<0.7x(70%)
WhatxisxGOLDx1xcriteria?x-xMild
FEV1x>/=x80%xpredicted
WhatxisxGOLDx2xcriteria?x-xModerate
FEV1x50-79%xpredicted
WhatxisxGOLDx3xcriteria?x-xSevere
FEV1x30-49%xpredicted
WhatxisxGOLDx4xcriteria?x-xVeryxsevere
FEV1x<30%xpredicted
,WhatxarexthexsignalxsymptomsxofxCOPD?x-xDyspnea
Chronicxcoughxw/sputum
Decreasedxactivityxtolerance
Wheezing
WhatxarexcharacteristicsxofxCOPD?x-xCommon,xpreventable,xtreatable.
Characterizedxbyxpersistentxairflowxlimitation.
Usuallyxprogressive,xassociatedxwithxenhancedxchronicxinflammatoryxresponsexinxairway
sxandxlungsxtoxnoxiousxparticles/gases
Airwayxfibrosis,xluminalxplugs,xairwayxinflammation,xincreasedxairwayxresistance,xsmallxai
rwayxdz.
Decreasedxelasticxrecoilxofxalveoli.
WhatxarexriskxfactorsxforxCOPD?x-xSmokingx(increasingxw/numberxofxpackxyears)
Secondxhandxsmoke
Environmentalxpollutionx(endotoxins,xcoalxdust,xmineralxdust)
WhatxisxseenxonxphysxexamxinxCOPD?x-xMayxbexnormalxinxearlyxstates
Asxseverityxprogresses:xlungxhyperinflation,xdecreasedxbreathxsounds,xwheezesxatxbases
,xdistantxheartxtonesx(b/cxofxhyperinflation,xsoxS1/
S2xsoundsxoffxinxdistance),xaccessoryxmusclexuse,xpursedxlipxbreathing,xincreasedxexpira
toryxphase,xneckxveinxdistention.
HowxisxCOPDxdiagnosed?x-xSpirometryxisxgoldxstandardx(prexandxpostxbronchodilator).
Irreversiblexairflowxlimitationxisxhallmark.
HowxisxCOPDxtreated?x-xBronchodilators:xbetaxagonistsx(long/
short),xanticholinergicsx(long/short),xorxcombo.
WhatxisxthexMOAxofxbetaxagonists?x-xStimulatesxbeta-2-
adrenergicxreceptors,xincreasingxcyclicxAMP,xresultingxinxrelaxingxairways.
WhatxisxthexMOAxofxanticholinergics?x-
xBlockxthexeffectxofxacetylcholinexonxmuscarinicxtypex3xreceptors,xresultingxinxbronchodilat
ion.
Whyxarexlong-actingxbetaxagonistsxprescribedxforxCOPD?x-
xTheyxarexforxmoderatexairflowxlimitation.
, Theyxrelievexsymptoms,xincreasexexercisextolerance,xreducexnumberxofxexacerbations,xi
mprovexQOL.
WhatxarexsomexnonxpulmonaryxdiagnosesxthatxresultxinxCOPD-typexsymptoms?x-xCHF
Hyperventilationxsyndrome
Panicxattacks
Vocalxcordxdysfunction
Obstructivexsleepxapnea
Aspergillosis
Chronicxfatiguexsyndrome
Whatxarexsignalxsymptomsxofxasthma?x-xWheezing
Shortnessxofxbreath
Coughx(espxatxnight)
Chestxtightness
Whatxisxchronicxbronchitis?x-xDailyxchronicxcoughxw/
increasedxsputumxforxatxleastx3xconsecutivexmonthsxinxatxleastx2xconsecutivexyears.
Usuallyxworsexonxwakening.
MayxorxmayxnotxbexassociatedxwithxCOPD.
Whatxisxemphysema?x-
xCharacterizedxbyxobstructionxtoxairflowxcausedxbyxabnormalxairspacexenlargement xdistal
xtoxterminalxbronchioles.
Chronicxinflammation/remodeling,xtrappingxair,xhinderingxeffectivexO2/
CO2xexchangex(allxduextoxinflammatoryxmediatorsxinfiltratingxairways).
Whatxarexsignalxsymptomsxofxischemicxheartxdz?x-xChestxpain
Chestxtightness
Chestxdiscomfort
Whatxisxischemicxheartxdz?x-
xImbalancexbetweenxsupplyxandxdemandxforxbloodxflowxtoxmyocardium
WhatxarexsignalxsymptomsxofxlungxCA?x-xCough
Dyspnea
Wtxloss
Anorexia
Hemoptysis
WhatxisxlungxCA?x-xMalignantxneoplasmxoriginatingxinxparenchymaxofxlung/airways
WhatxarexsignalxsymptomsxofxMI?x-xProlongedxCPx(>20minxduration)
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