CMN 568 -Unit 3 Combo (Questions With Solutions)
For moderate persistant asthma, symptoms occur Right Ans - Daily
For moderate persistant asthma, SABA use is Right Ans - Daily
For moderate persistant asthma, nighttime awakenings ages 0-4 Right Ans
- 3-4 times/month
For moderate persistant asthma, nighttime awakenings for >5 Right Ans - >
once a week, not nightly
For moderate persistant asthma, interference with normal activity Right
Ans - Some
For moderate persistant asthma, Lung function FEV1 or PEF (personal best),
>12 Right Ans - 60-80&
For moderate persistant asthma, FEV1/FVC, ages 5-11 Right Ans - 75-80%
For moderate persistant asthma, FEV1/FVC ages over 12 Right Ans - less
than 5%
For moderate persistant asthma, exacerbations requiring oral corticosteroids,
ages 0-4 Right Ans - >=2times/6 months or >= 4 wheezing episodes in a
year that last longer than a day AND risk factors for persistent asthma.
For moderate persistant asthma, exacerbations requiring oral corticosteroids,
>= 5 years Right Ans - >= 2 times/year of exacerbations
For moderate persistant asthma, exacerbations, recommended step for
starting treatment Right Ans - Step 3 and reevaluate in 2-6 weeks
After starting treatment for asthma, you should reevaluate the patient in
Right Ans - 2-6 weeks
When is treatment not appropriate when using SABAs PRN? Right Ans -
When more than 1 canister/month is used
,Can LABAs be used as mono therapy? Right Ans - No, administer with ICS
What is the action of Theophylline? Right Ans - relaxes and opens airways,
rarely used because it requires careful monitoring
How and why is Omalizumab given? Right Ans - Sub-q every 2-4 weeks;
given to patients over 12 with mod to persistent asthma with positive skin
test.
What is the action of ICS? Right Ans - prevent inflammation of the airways
What is the hallmark on CXR for miliary TB? Right Ans - Snowstorm
Treatment of TB in pregnancy: Right Ans - 2 mos: INH, RIF, EMB
7 mos: INH, RIF
What drug cannot be used in pregnancy when treating TB? Right Ans - PZA
Side effect of RIF? Right Ans - Orange secretions
SIde effect of PZA? Right Ans - Hyperuricemia; hepatotoxicity - (reason not
given in LTBI)
Side effect of EMB: Right Ans - optic neuritis
Side effect of INH: Right Ans - Peripheral neuropathy
What drug is added to INH therapy? Right Ans - Vit B6
A false negative TB test can result in: Right Ans - malnourished,
overwhelming disease, 10% of kids
Does a negative TST exclude TB? Right Ans - No
You should consider COPD, and perform spirometry if any of these indicators
are present in an individual over age 40: Right Ans - Dyspnea (progressive,
worse with exercise, persistent daily, described as air hunger, gasping, etc),
Chronic cough, chronic sputum production, and history of exposure (tobacco
,smoke, occupational dusts and chemicals, smoke from home cooking and
heating fuel)
Diagnosis of COPD should be confirmed by Right Ans - Spirometry and
clinical symptoms and signs
Why is a low peak flow inconsistent with diagnosing COPD? Right Ans -
poor specificity; low peak flow can be caused by other diseases and by poor
performance
What drug is contraindicated in COPD and asthma? Right Ans - Beta
blockers
Stage III - Severe COPD has a FEV1 of Right Ans - FEV1<50% predicted
Stage 1 - Mild COPD has a FEV1 of Right Ans - FEV1> 80% predicted
Stage 4 - Very severe COPD has a FEV1 of Right Ans - FEV1<30% predicted
Stage 2 - Mod COPD has a FEV1 of Right Ans - FEV1<80% predicted
All COPD patients have a FEV1/FEV of Right Ans - <70% or 0.70
When are bronchodilators prescribed in COPD? Right Ans - As needed to
relieve intermittent or worsening symptoms, and on a regular basis to prevent
or reduce persistent symptoms
When are inhaled glucocorticoids prescribed in COPD? Right Ans -
symptomatic patients with an FEV1<50% predicted and repeated
exacerbations.
Mild COPD treatment Right Ans - Flu vaccine,SABA
Mod COPD treatment Right Ans - Flu vaccine, SABA, LABA, Rehab
Severe COPD treatment Right Ans - Flu vaccine, SABA, LABA, Rehab, ICS
Very severe COPD treatment Right Ans - Flu vaccine, SABA, LABA, Rehab,
ICS, O2 (worn 15 hrs/daily)
, SABAs: Right Ans - Levalbuterol, Albuterol, Terbutaline, Fenoterol
LABAs: Right Ans - Formoterol, Salmeterol, Indacaterol, Arformoterol
Anticholinergics: Right Ans - Ipratropium bromide
ICS: Right Ans - Budenoside, Fluticasone, Beclomethasone
Systemic Glucocorticoids: Right Ans - Prednisone, Methylprednisolone
Characteristics of Emphysema: Right Ans - Usually over 50 y/o, insidious
progressive dyspnea, no cough, scant, clear sputum, hyperressonance,
decreased breath sounds
Characteristics of chronic bronchitis Right Ans - Usually over 35 y/o,
recurrent cough, PFT normal or decreased lung capacity with residual volume,
sputum is copious mucopurulent
Asthma > 12 yrs: Step 4 is treated with _____. Right Ans - Medium dose ICS
and LABA
Asthma > 12 yrs: Step 1 is treated with ____. Right Ans - SABA PRN
Asthma >12 yrs: Step 3 is treated with ____. Right Ans - Low dose ICS and
LABA or Med ICS
Asthma >12 yrs: Step 2 is treated with _____. Right Ans - Low dose ICS
Asthma > 12 yrs: Step 5 is treated with ____. Right Ans - High dose ICS and
LABA and consider omalizumab
Asthma > 12 yrs: Step 6 is treated with____. Right Ans - High dose ICS and
LABA and oral corticosteroid and consider omalizumab.
What is the isoniazid chemoprophylaxis treatment if exposed to TB? Right
Ans - 10mg/kg/d x 2 months after last contact, then Mantoux test, continue
therapy for 7 months if positive.