Medical Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 56. Why is diaphragmatic breathing not usually recommended for patients with chronic obstructive pulmonary disease?Diaphragmatic breathing or deep breathing is done by contracting the diaphragm. Mr. Smith, an 80-year old smoker, has stage II COPD. COPD, or Chronic Obstructive Pulmonary Disease, is a disorder that affects millions of people around the world. Death is imminent. Because COPD causes wasting, weight gain resulting from smoking cessation is not much of a problem. The best way to improve your performance on IM board review questions is to use specific board exam test strategies and to take lots of practice questions. Quickly memorize the terms, phrases and much more. You have created 2 folders. There is a decrease in vital capacity (VC), inspiratory reserve volume (IRV), expiratory reserve volume (ERV), and a normal forced expiratory volume in one second (FEV1) and forced vital capacity (FVC 78) that is 83% if less than 50% significant disease. What is the most appropriate antibiotic therapy for COPD exacerbation in a patient that failed initial treatment? [. Ambulance attendance is often triggered by a respiratory infection. Recently Added Questions The image shown below is a Wright-Giemsa stained bone marrow aspirate smear from a child who presented with a 5 cm abdominal mass. BoardVitals Pulmonary and Critical Care Medicine CME Pro Plus offers more than 600+ peer-reviewed online case-style questions that will help you prepare for your board exams and stay up-to-date on relevant Pulmonary and Critical Care Medicine topics including Obstructive Lung Disease, Cardiovascular Disorders, and Gastrointestinal Disorders. This could include noninvasive ventilation (BiPAP, CPAP, etc.) Asthma B. COPD C. Neither D. Both. 24. What interventions are used for all severities of COPD? What is the best care approach suited for chronic obstructive pulmonary disease?Palliative care and home health, 43. Emergency Medicine board review. 47. And here's a free pulmonary board review video from CMEinfo.com, a teaser for their pulmonary CME and pulmonary board review products: Bronchial Asthma 3. 10. What are two major ways to diagnose COPD?Clinical assessment/history and Spirometer to measure volumes, capacities, and flow of air. Methods We analyzed data from 408,774 respondents aged 18 or older in the 2016 Behavioral Risk Factor Surveillance Syste… 32. Pulmonary Medicine Board Review Questions. CBABE is a mnemonic that can be used as a simple way to learn and memorize all of the obstructive diseases. What is the cornerstone of asthma therapy? Thank you so much for reading and as always, breathe easy my friend. It is signed by two doctors. Patients suffering from chronic obstructive pulmonary disease relay more on the accessory muscle of the neck, shoulders and back to breathe rather than the diaphragm. Note: since these questions are being incorporated into our new Board Review page, this page will soon disappear. Clearly identified objectives enable the board to set specific goals for the evaluation and make decisions about the scope of the review. Which of the following is not consistent with the diagnosis of asthma: How long does it take for clinical effects to be seen from ICS or LTRA therapy? That wraps up our study guide on COPD. Now you not only know the medical definition, you also know how to treat a patient who is showing signs of an acute COPD exacerbation. What is the effect of bronchodilators on the decline in lung function?Drugs don’t change the progressive decline in lung function. 38. Losartan 50 mg, HCTZ 12.5 mg, Amlodipine 5 mg daily, Tamsulosin (Flomax) 0.8 mg daily, Atorvastatin (Lipitor) 10 mg daily, Albuterol inhaler 2 puffs PRN for SOB, tiotropium (Spiriva) once daily What nail finding is commonly seen with chronic obstructive pulmonary disease?Clubbed fingers, 59. “Chronic Obstructive Pulmonary Disease: An Overview.” PubMed Central (PMC), 1 Sept. 2008. What is hypercapnia?Above normal PaCO2, 40. When is it appropriate to use systemic steroids?The appropriate use of systemic steroids is when nothing else works. There is a good summary on the official BSA site. What is the etiology of chronic obstructive pulmonary disease and lung damage risk factors?Smoking, genes, age and gender, lung growth and development, exposure to particles, social status and deficiency of serine protease inhibitor alpha 1 anti-trypsin (AAT). Not to be used as monotherapy. What are the three primary symptoms of COPD?Cough, sputum production, and dyspnea on exertion. Best antibiotic choices for severe COPD flare: If a patient reports orthopnea as part of a pulm problem, what should you consider. True or False: COPD is reversible and tends to happens gradually. Avoid dry and cold air. First of all, it is important to be familiar with the procedures and purposes of a Board of Review. 19. What is not a benefit of long-term oxygen therapy?Better absorption of medications and better mental functioning. How many times is a smoker more likely to die of chronic obstructive pulmonary disease than a non-smoker?10 times. What is a noninvasive type of ventilation?Noninvasive positive-pressure ventilation or NPPV, 53. Next, we will discuss the treatment methods for COPD. T/F: all patients with asthma should have a SABA inhaler. For treatment of thin and thick mucus, use of mucolytic, percussion and postural drainage (P&PD), ultrasonic nebulizer (usn) and heated aerosol. Pneumonia Try this amazing COPD Test 3 quiz which has been attempted 1358 times by avid quiz takers. Reflection: A board review will touch on many elements mentioned in previous questions. The following are the general methods for treating a patient with COPD: This book provides a straightforward overview of Chronic Obstructive Pulmonary Disease. “CDC – Basics About COPD – Chronic Obstructive Pulmonary Disease (COPD).” Centers for Disease Control and Protection, 19 July 2019. What can be observed on the result of a complete blood count (CBC) of patients with advanced stage of chronic bronchitis?For male, RBC (red blood cell) 4.6-6.2 million/UL with Hgb 13-18 gm/dl and for female, RBC 4.2-5.4 million/UL with Hgb12-16 gm/dl. Pulmonary function testing shows decreased expiratory maneuver, forced vital capacity (FVC) of lung volume and capacity is increased along with ventricular tachycardia (Vt), right ventricle (RV), residual volume/total lung volume (RV/TLC) and functional residual capacity (FRC). 66. 1. 18. Breath sounds and x-ray have no significant changes. 72. Who should undergo spirometry testing to detect chronic obstructive pulmonary disease?Smokers or ex-smokers 40 years of age and older who have the symptoms. What type of chronic obstructive pulmonary disease is referred as a “pink puffer”?Emphysema, 60. Enlargement of airspaces distal to the terminal bronchiole. Chronic bronchitis is an increase production of mucus from bronchi. What is the effect on airflow in terms of chronic obstructive pulmonary disease?Obstruction and/or limitation that is not completely reversible. www.ncbi.nlm.nih.gov/pmc/articles/PMC4106574, www.ncbi.nlm.nih.gov/pmc/articles/PMC3657849, www.ncbi.nlm.nih.gov/pmc/articles/PMC4131503, www.ncbi.nlm.nih.gov/pmc/articles/PMC6545670, Obstructive Lung Diseases: COPD, Asthma, and Related Diseases, Amazing Tips for Surviving Respiratory Therapy School, Asthma Practice Questions for Respiratory Therapy Students, Bronchiectasis Practice Questions for Respiratory Therapy Students, Chronic Bronchitis Practice Questions for Respiratory Therapy Students, Avoid triggers and recurrent infections (such as the flu and pneumonia), Egan’s Fundamentals of Respiratory Care. What are other ways to diagnose chronic obstructive pulmonary disease?Laboratory values, electrocardiogram (EKG), arterial blood gas (ABG) and chest x-ray (CXR). These are all common questions from students enrolled in certain medical school programs. 58. Introducing Cram Folders! Diseases of the Respiratory System 2. 69. Chronic Obstructive Pulmonary Disease(COPD) 4. 22. In the examples below, the correct answer always won out, but other answer choices made a respectable showing, indicating that our distractors did their job well for Question of the Week respondents. What heart problem is caused by chronic obstructive pulmonary disease?Cor pulmonale, 52. 64. NEJM Knowledge+ Internal Medicine Board Review, Family Medicine Board Review, and Pediatrics Board Review are produced by NEJM Group, the organization behind the New England Journal of Medicine, NEJM Journal Watch, NEJM Catalyst, and NEJM Resident 360. The client’s history includes chronic obstructive pulmonary disease (COPD) and coronary artery disease. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. View 0 peer reviews of Anxiety and Depression in COPD Current Understanding, Unanswered Questions, and Research Needs on Publons COVID-19 : add an open review or score for a COVID-19 paper now to ensure the latest research gets the extra scrutiny it needs. Encourage advancement to 2nd Class. emboardbombs.com What are three classes of medications used in asthma for their anti-inflammatory properties? Zafirlukast is. 49. What are criteria for well-controlled asthma or asthma that is intermittent and does not require controller therapy? So here are 80 free pulmonary and critical care board review questions to help sharpen your brain to a test-slicing razor's edge. Bronchodilator. Figure 44.1. What is the best ABX choice for a 52 year old man with an acute exacerbation of Stage II COPD? What contributes most to chronic obstructive pulmonary disease?The number of pack-years that the patient smoked. Also explore over 14 similar quizzes in this category. The primary goal of treating COPD is to increase the patient’s life expectancy and quality of life while decreasing the number of COPD exacerbations and hospital visits. 22. What type of chronic obstructive pulmonary disease presents more commonly with a cough and sputum?Chronic bronchitis, 62. Please sign in to share these flashcards. 46. During these extraordinary times, caring for patients with COVID-19 and underlying COPD poses particular challenges. 50. 7. Characteristic timing of symptoms that suggests asthma: A worsening of asthma symptoms may be seen after: What is necessary to make the diagnosis of asthma: When is peak flow metering done re: asthma? So if you’re ready, let’s get started. Bronchial Asthma 3. What are the pulmonary symptoms characteristic of COPD? What type of gastric problem is caused by long term corticosteroid use? Subjects: ancc anp asthma boards copd fitzgerald np. Internal Medicine Board Review Flashcards - This eBook contains 50 Pulmonary Disease and Critical Care Flashcards. 11. Pneumonia 35. What are some other causes of chronic obstructive pulmonary disease?Long term work environments that is smoky or dusty. What common misconceptions about chronic obstructive pulmonary disease?Lower respiratory infections usually increase once a patient quits smoking. Advanced signs of chronic bronchitis includes a chronic cough with increased mucus, increased respiratory rate (RR), heart rate (HR), carbon dioxide (CO), blood pressure (BP), dyspnea especially with exertion, increased work of breathing (WOB) with prolonged expiration, diagnostic palpation/percussion, decreased tactile and vocal fremitus, hyper resonant percussion note in breath sounds, and decreased conditioned reflex (Cr). 6. Initial round-the clock management of COPD: Indication to add ICS to initial COPD management: tiotropium, an anticholinergic inhaler used for COPD management. What is the breath sounds in advanced chronic bronchitis?Crackles with wet secretions wheezes that leads to bronchoconstriction (mucus plug) and Rhinflamedflammed airways. What are three classes of medications used in asthma for their bronchodilating properties? 28. 3. 8. These early decisions about overal… What are the diagnostic test and result of chronic bronchitis?Chest x-ray (CXR) shows hyperinflation or air trapping, translucent or very dark, increased A-P diameter (barrel chest), flattened Diaphragm or blunted costophrenic angle, spider like projection in the bronchogram, and enlarged heart. What is chronic bronchitis?Chronic bronchitis is an increase production of mucus from bronchi. 70-85%, depending on age. Is there evidence to support tapering PO CS dose after asthma flare? Criteria for round-the clock treatment in COPD. What are available treatments for medical and respiratory of chronic bronchitis?Stop smoking to eliminate irritant. What is the general pathophysiology of COPD?Airflow limitation and air trapping; traps air in exhalation leading to hyperinflation; and breaks down of the alveolar walls, excess mucus inflamed lining and bronchial. Well, time is short. Please select the correct language below. What are the clinical manifestations of chronic bronchitis?Frequent cough with mucous expectorate, slight increase on respiratory rate (RR), and slight increase of heart rate (H), carbon dioxide (CO), blood pressure (BP), dyspnea only with lung infection. It doesn't get much better than this Respiratory Therapist Sweatshirt. Use for at least 15 hours/day, NOT just in response to dyspnea. Introducing Cram Folders! 2. What is the medical definition of COPD? Introduction More than 54 million US adults have arthritis, and more than 15 million US adults have chronic obstructive pulmonary disease (COPD). 20. 12. What will the Spirometry show for chronic obstructive pulmonary disease?There will be reductions in force expiratory volume in the first second (FEV1), strong predictor of mortality rate; FEV1/FVC (forced vital capacity) and mid-expiratory flow rate. Mindus S et al (2018) Asthma and COPD overlap (ACO) is related to a high burden of sleep disturbance and respiratory symptoms: results from the RHINE and Swedish GA2LEN surveys. What are the available treatments for chronic obstructive pulmonary disease?Smoking cessation, oxygen therapy, pharmacological therapy, and pulmonary rehabilitation. Facts to know about theophylline prescribing. Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Free, short podcasts with high yield board and shelf exam review. The first few questions in the Board of Review should be simple. 13. A client with pneumonia is receiving supplemental oxygen, 2 L/min via nasal cannula. The objective of this study was to assess the relationship between self-reported physician-diagnosed COPD and arthritis in the US adult population. Grab yours today. 33. Ipratropium bromide, when used in COPD provides which therapeutic effect: What is the pathophysiology of emphysema? QUESTION 10–14. When should a hospice referral be made for a COPD patient?When the disease enters Stage III-IV, 41. He was previously a professor of respiratory medicine and a consultant physician at St George's, University of London in London, UK. Just simply break it down and use each letter as follows: Again, you can easily memorize this acronym as a simple way to learn which disorders are classified as obstructive diseases. Background Conventional measures to evaluate COPD may fail to capture systemic problems, particularly musculoskeletal weakness and cardiovascular disease. COPD, or Chronic Obstructive Pulmonary Disease, is a chronic respiratory disease that causes progressive airway obstruction which results in breathing-related problems. It’s a worsening state of COPD that usually indicates that the patient is in need of increased medication dosages or other forms of care. What is the main risk factor for chronic obstructive pulmonary disease?Smoking, 39. 29. 5. 4. According to GOLD COPD guidelines, what medication is indicated for stages I to IV? What does FEV1 stand for?Forced Expiratory Volume in the first second. The Board of Review should try to gain a sense of how the Scout is fitting in to the Troop, and the Scout's level of enjoyment of the Troop and Patrol activities. A patient with a myocardial infarction (MI) is at risk for left-sided heart failure. The Board of Review should try to gain a sense of how the Scout is fitting in to the Troop, and the Scout’s level of … most common severity of asthma seen in clinical practice. What is the difference between chronic obstructive pulmonary disease and asthma?Chronic obstructive pulmonary disease (COPD) is not reversible and asthma is. Assess based on last 4 weeks. 2. Paul W. Jones, MD, PhD, is the global medical expert for the respiratory franchise at GSK. 51. 67. What are the changes in breath sounds in early chronic bronchitis?No significant changes. What are the criteria for home oxygen use?PaO2<55% or SaO2 <88% on room air taken 2 times over 3 weeks period in stable patient and PaO2 55-60% if evidence of pulmonary hypertension (HTN), congestive heart failure (CHF), or polycythemia. What are the COPD severity staging guidelines?The Global Initiative for Chronic Obstructive Lung Disease (GOLD) staging systems are: Stage 1 or Mild COPD, patients with FEV1 (forced expiratory volume in one second) <80% of predicted. 8th ed., Mosby, 2019. It is not from a specific disease. Identifying these manifestations and assessing their association with clinical outcomes (ie, mortality, exacerbation and COPD hospital admission) is of increasing clinical importance. 17. We'll bring you back here when you are done. 10. You can be assured that we’ve applied the same high standards to the thousands of board review questions and … What characteristic is in chronic obstructive pulmonary disease?This disease involves abnormal inflammation. There is also a training module which you can use to educate your Committee members. What are indications that antibiotic therapy may be needed in COPD flare? How We Create Content. What are the three causes of chronic bronchitis?Smoking, recurring pulmonary infections as a child may increases susceptibility and air pollution, 25. Different preparations are NOT interchangeable mg to mg. Clinical uses of anticholinergics (ipratropium and tiotropium). “Treatment of COPD: The Simplicity Is a Resolved Complexity.” PubMed Central (PMC), 5 Sept. 2020. BiPAP (Bilevel Positive Airway Pressure) is preferred during an acute exacerbation of COPD in order to avoid intubation. Such issues as the complexity of the performance problem, the size of the board, the stage of organisational life cycle and significant developments in the organisation’s competitive environment will determine the issues the board wishes to evaluate. It is pertinent to establish a baseline in order to start treatment and follow-up to track the progression of this disease. What is a COPD Exacerbation? Pulmonary disease and critical care are an extremely important part of the Internal Medicine Medical Clerkship and ABIM Board exam. What are the criteria for home oxygen use? Change in a patient's baseline dyspnea, cough and/or sputum beyond day-to-day variability sufficient to warrant a change in management. Findings on exam during an acute asthma or COPD flare: Peak Expiratory flow. It can be used in asthma that is uncontrolled on optimized conventional therapy. Prevents the breakdown of cAMP (which causes bronchial relaxation) by phosphodiesterase. Coronavirus SARS-CoV-2 is currently causing a pandemic of COVID-19, with more than 3 million confirmed cases around the globe identified as of June 2020. 31. Miravitlles M et al (2014) Generic utilities in chronic obstructive pulmonary disease patients stratified according to different staging systems. What are the potential complications of chronic obstructive pulmonary disease?Polycythemia (elevated RBC (red blood cell)), infection, atelectasis, pneumonia, pulmonary hypertension and respiratory insufficiency or failure. Identify this brand name medication used in COPD maintenance: Advair HFA, Identify this brand name medication used in COPD maintenance: Symbacort, Identify this brand name medication used in COPD maintenance: Combivent, ipratropium bromide and albuterol (anticholinergic + SABA). How much of an ICS dose is absorbed systemically? What are two methylxanthine bronchodilators? To help, we put this COPD study guide together in hopes that it makes the learning process a bit easier for you. What is chronic obstructive pulmonary disease (COPD)?It stands for Chronic Obstructive Pulmonary Disease. What is the most common cause of chronic obstructive pulmonary disease?Smoking. why is montelukast superior to zafirlukast? 70. Clinical Manifestations and Assessment of Respiratory Disease. Best antibiotic choice for mild or moderate COPD flare: Doxycycline, which covers DRSP and atypicals. Cram has partnered with the National Tutoring Association. What is the pathophysiology of chronic bronchitis?Inhale irritant, bronchial walls inflame and bronchial mucous glands enlarged, 26. So there you have it. We weren't able to detect the audio language on your flashcards. Now you should have a decent understanding of the basic concepts of COPD. An adult male patient on ventilatory support has just been intubated with a 7.0 mm oral endotracheal tube equipped with a high residual volume low-pressure cuff. 14. Based on his medications, what is the most predictable drug-disease interaction? What are the physical findings of chronic obstructive pulmonary disease?Barrel chest, cyanosis of mucosal membranes, increased resting respiratory rate, shallow breathing, and pursed lips during respiration. Severity is based on most bothersome symptom. 36. Thereafter knowledge of an annual review will undoubtedly lead to more conscious governance and opportunities to introduce improvements (including replacement of board members). 9. How can you treat a patient with COPD? What device must be surgically implanted?Transtracheal catheter, 55. However, if the patient’s condition worsens, intubation and conventional mechanical ventilation would be indicated. This is measured by a peak flow meter and is used for monitoring. They will only help dilate the bronchotracheal tree to help aide air movement and mucus movement. What are non-pharmacologic measured to be encouraged in all patients with COPD: FEV1 is usually reduced as the disease progresses, but may be normal in early stages. Obtaining buy-in for the first review might prove painful. What medications are used in the management of COPD?These are racemic epinephrine, Albuterol/Proventil (ventilin), Levalbuterol (xopenex), Salmeterol, Formoterol, Arformoterol (brovana), Ipratropium (atrovent), Tiotropium (sprivia), Budesonide (pulimcort), Mometasone (asmanex), Fluticasone (Flovent), Beclomethasone (QVAR), Acetylcysteine (mucomyst), and Dornase alpha (rhDNAse), and Nedocromil (tilade). Please upgrade to Cram Premium to create hundreds of folders! 30. AKA phopsphodiesterase inhibitor. The most common causes of COPD include the following: In the United States, tobacco smoke is the leading preventable cause of COPD. Add LABA and/or anticholniergic if needed. “Chronic Obstructive Pulmonary Disease.” PubMed Central (PMC), 1 Feb. 2013. Improve bronchial hygiene by humidifying oxygen (O2) when necessary. What is the progressive nature of chronic obstructive pulmonary disease and why is it important to establish a baseline and follow up?Chronic obstructive pulmonary disease will get worse over a progressive period of time. Change in purulence or quantity of sputum. I hope that you’ll be able to use this information to prepare for your exams and boost your knowledge as a medical professional. What are the general symptoms of COPD?Dyspnea, cough, sputum, fever, wheezing, chest tightness, and fatigue. Find out how you can intelligently organize your Flashcards. montelukast is not an CYP inhibitor. What is the preferred long-term steroid administration route and why is it preferred?It is inhaled administration route because they don’t have the side effects of systemic steroids. Avoid other lung infections. The patient has a chronic productive cough with dyspnea on excretion. These board review questions and guide are created by PulmCCM contributors and are not eligible for ACCME / AMA PRA Category 1 Credit TM nor endorsed by any educational or professional entity. The Flashcards are review questions and can be used to study for medical board exams including the USMLE Step Exams and the ABIM Internal Medicine Exam. The following are the sources that were used while doing research for this article: Disclosure: The links to the textbooks are affiliate links which means, at no additional cost to you, we will earn a commission if you click through and make a purchase. A patient is presenting with chronic obstructive pulmonary disease. 15. A decrease is seen with aging. 57. Rationale for tapering corticosteroid dose: Long-term use causing adrenal insufficiency. All patients with COPD are required to have an annual review to check their symptom control, inhaler technique, lung function, oxygen saturation if required, have a general medication and physical health check, offer help if smoking and review an individual care plan for what to do if become unwell. Is asthma a reason to limit physical activity? Please consult with your physician with any questions that you may have regarding a medical condition. 34. The first stage of the board evaluation process is to establish what the board hopes to achieve. PLOS ONE; 13: 4, e0195055. What are the advanced stages of chronic bronchitis?Larger airways plug, V/Q (ventilation/perfusion) mismatch, pulmonary arteries constrict and polycythemia, 27. “Chronic Obstructive Pulmonary Disease Exacerbations: Latest Evidence and Clinical Implications.” PubMed Central (PMC), 1 Sept. 2014. COPD360social Questions and Answers is the one stop shop to share thoughts and ideas, receive and provide support as well as ask the community about … Click Here for COVID-19 Information for the COPD Community: Updated December 22nd! What are the differences on the major symptoms between chronic bronchitis and emphysema?In chronic bronchitis, symptoms consist of excessive sputum production for at least 3 months for a year and twice in a row while emphysema’s symptoms consist of the destruction of the gas exchange surfaces. The first few questions in the Board of Review should be simple. Mosby, 2020. 71. What is chronic bronchitis? The process may require some explanation on the part of the Board of Review Chairperson. Printed review handout sheets on exam review topics. What are the characteristics of chronic bronchitis?Chronic bronchitis is characterized by a productive cough that lasts at least three months with recurring bouts occurring for at least two consecutive years, copious amounts of mucus production, airway obstruction due to bronchial inflammation and destruction of the pulmonary acini. Arthritis and COPD share many risk factors, such as tobacco use, asthma history, and age. What type of COPD has “quiet” breath sounds without adventitious sounds on auscultation?Emphysema. Posteroanterior chest x-ray for Question 9. Sometimes committee members struggle to come up with good Board of Review questions. You in the Board of Review Chairperson medicine and a consultant physician at St George,! That it makes the learning process a bit easier for you ABG ) has slight respiratory alkalosis with mild (! ) by phosphodiesterase with any questions that you can dive even deeper this. 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