Exam (elaborations)
ACNP Final Exam - Questions With Complete Solutions
- Course
- Institution
ACNP Final Exam - Questions With Complete Solutions
[Show more]
Content preview
ACNP Final Exam - Questions With Complete SolutionsWhat is the difference between chronic bronchitis and emphysema? Right
Ans - Bronchitis: chronic productive cough for three months in each of two
successive years in which other causes of chronic cough have been excluded
(Blue Bloater)
Emphysema: abnormal and permanent enlargement of airspaces that are
distal to terminal bronchioles (pink puffer), destruction of airspace walls
(fibrosis is not obvious), MUST have obstruction deficit
What are other causes of chronic cough that need to be excluded before COPD
diagnosis? Right Ans - - gerd
- ACEI use
- vocal cord dysfunction
Chronic Bronchitis clinical exam Right Ans - - stocky/obese
- over 35 yo
- normal AP
- central cyanosis
- persistent cough
- intermittent dyspnea w sputum production
- wheeze and rhonchi (bc so much sputum)
- RHF (JVD, peripheral edema)
Emphysema clinical exam Right Ans - - thin, weight loss, cachetic
- over 50 yo
- increased AP (bc lungs are hyperinflated)
- no central cyanosis
- tripod breathing
- NO COUGH, and hardly any sputum
- hyperresonant percussion
- decreased breath sounds
What diagnostic tests would we use to diagnose COPD? Right Ans - - PFT
(required for diagnosis and completed AFTER exacerbation)
- CXR
- ABG
, - Alpha 1 antitrypsin deficiency screening (usually under 45 yo, fam history,
nonsmoker, consolidations will appear in lower lobes)
What would COPD PFTs look like? Right Ans - - FEV1 less than 80%
- FEV1/FVC less than 70% (normal is 80)
- DLCO decreases in proportion to severity of emphysema
- no improvement in PFTs with bronchodilator
Mild - Stage 1 COPD Right Ans - - FEV1/FVC <70%
- FEV1 greater than or equal to 80% predicted
- chronic cough/sputum
Moderate - Stage II COPD Right Ans - - FEV1/FVC <70%
- FEV1<80% but >50% predict
- SOB, DOE
- seek medical attention
Severe - Stage III COPD Right Ans - - FEV1/FVC < 70%
- FEV1<50% but >30% predicted
Very Severe - Stage IV COPD Right Ans - - FEV1/FVC < 70%
- FEV1 < 30% predicted or <50% plus chronic respiratory failure
- exacerbations may be life threatening
Modified Medical Research Council (MMRC) Dyspnea Scale Right Ans -
Five components of Staging COPD Right Ans - - confirm PFT
- FEV1/FVC < 70%
- Exacerbation history
- MMRC scale 0-4
GOLD 2018 Classification Right Ans -
CT Results of emphysema Right Ans - Emphysema: kissing lungs, bullae
How would you treat a COPD exacerbation? Right Ans - - SABA with or
without SAMA
- maintenance therapy with long acting bronchodilators initiated ASAP
- systemic corticosteroids ( 5-7 days)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller LeCrae. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81113 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now
