NR601 MIDTERM EXAM|| ALL QUESTIONS AND
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What are the 3 primary physiological changes of aging? - ANSWER:
1. Reduced physiological reserve of most body systems, esp. cardiac, resp, renal.
2. Reduced homeostatic mechanisms that fail to adjust regulatory systems (i.e.
temp control, fluid/lyte balance, etc.).
3. Impaired immunological function (infection risk is greater, autoimmune dz's
more prevalent)
What is the preferred amount of exercise for elderly? - ANSWER: 30min/day 5
days/wk of moderate exercise.
If trying to lose wt: 60min/day.
What are PFTs? - ANSWER: Group of tests that provide quantifiable
measurement of lung function, used to dx resp abnormalities or assess
progression/resolution of lung dz.
What is FEV1? - ANSWER: Forced Expiratory Volume in 1 second (80-120%)
What is FVC? - ANSWER: Forced Vital Capacity (80-120%)
,2|Pag e
What is normal FEV1/FVC ratio? - ANSWER: <0.7 (70%)
What is GOLD 1 criteria? - ANSWER: Mild
FEV1 >/= 80% predicted
What is GOLD 2 criteria? - ANSWER: Moderate
FEV1 50-79% predicted
What is GOLD 3 criteria? - ANSWER: Severe
FEV1 30-49% predicted
What is GOLD 4 criteria? - ANSWER: Very severe
FEV1 <30% predicted
What are the signal symptoms of COPD? - ANSWER: Dyspnea
Chronic cough w/sputum
Decreased activity tolerance
Wheezing
What are characteristics of COPD? - ANSWER: Common, preventable, treatable.
Characterized by persistent airflow limitation.
Usually progressive, associated with enhanced chronic inflammatory response in
airways and lungs to noxious particles/gases
What are risk factors for COPD? - ANSWER: Smoking (increasing w/number of
pack years)
Second hand smoke
Environmental pollution (endotoxins, coal dust, mineral dust)
What is seen on phys exam in COPD? - ANSWER: May be normal in early states
As severity progresses: lung hyperinflation, decreased breath sounds, wheezes at
bases, distant heart tones (b/c of hyperinflation, so S1/S2 sounds off in distance),
accessory muscle use, pursed lip breathing, increased expiratory phase, neck vein
distention.
How is COPD diagnosed? - ANSWER: Spirometry is gold standard (pre and post
bronchodilator).
Irreversible airflow limitation is hallmark.
How is COPD treated? - ANSWER: Bronchodilators: beta agonists (long/short),
anticholinergics (long/short), or combo.
What is the MOA of beta agonists? - ANSWER: Stimulates beta-2-adrenergic
receptors, increasing cyclic AMP, resulting in relaxing airways.
, 4|Pag e
What is the MOA of anticholinergics? - ANSWER: Block the effect of
acetylcholine on muscarinic type 3 receptors, resulting in bronchodilation.
Why are long-acting beta agonists prescribed for COPD? - ANSWER: They are
for moderate airflow limitation.
They relieve symptoms, increase exercise tolerance, reduce number of
exacerbations, improve QOL.
What are some non pulmonary diagnoses that result in COPD-type symptoms? -
ANSWER: CHF
Hyperventilation syndrome
Panic attacks
Vocal cord dysfunction
Obstructive sleep apnea
Aspergillosis
Chronic fatigue syndrome
What are signal symptoms of asthma? - ANSWER: Wheezing
Shortness of breath
Cough (esp at night)
Chest tightness
What is chronic bronchitis? - ANSWER: Daily chronic cough w/increased sputum
for at least 3 consecutive months in at least 2 consecutive years.
Usually worse on wakening.
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