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A set of practice questions and answers related to chronic obstructive pulmonary disease (copd). It covers various aspects of copd, including risk factors, diagnosis, treatment options, and management strategies. The questions are designed to test understanding of copd guidelines and clinical decision-making. It is useful for medical students, nursing students, and healthcare professionals preparing for exams or seeking to enhance their knowledge of copd management. Questions on medication choices, patient assessment, and appropriate interventions for copd exacerbations.
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A 25 year old smoker with a 10 pack year history of smoking should be given what counsel to prevent development of COPD? A. Use albuterol as needed to prevent symptoms B. Use ipratropium as needed to prevent symptoms C. Need for an influenza vaccination D. Smoking cessation information E. All of the above - ANSWER - D. Smoking cessation information The risk of theophylline toxicity is MOST likely to occur in a patient who has discontinued: A. Smoking B. Omeprazole C. Fluoxetine D. Warfarin E. Gentamicin - ANSWER - A. Smoking JJ is a 65 yom who comes to the clinic today for his annual visit. While reviewing his records you discover he has had 5 COPD exacerbations requiring hospitalization since his last visit a year ago. The most recent event occurred two months ago. Spirometry reveals a FEV1 of 29%. How should you classify this patient's COPD? A. Group A B. Group B C. Group C D. Group D - ANSWER - C, D (He didn't specify the the mMRC nor the CAT...)(I'm sure he was going for D, but not sure) A PDE-4 inhibitor is recommended as third choice in which of the following COPD groups? A. Group A B. Group B C. Group C D. Group D - ANSWER - C. Group C (Slide 98) Which of the following medications is recommended as third choice in all COPD classes? A. Ipratropium B. Theophylline C. Albuterol D. Anoro Ellipta E. Roflumilast - ANSWER - B. Theophylline A patient with a prior diagnosis of COPD approaches the pharmacy counter and asks for a refund on his Combivent inhaler. The patient states that he pays "a whole lotta money for a drug that doesn't work", and wants a replacement. He states that he knows the drug must be expired or old, because he has been using this drug for 3 years now...and for 2 months, it hasn't worked like it used to. Other than agitation, the patient is in no distress and has been hospitalized once in the last year for COPD exacerbation. Which of the following is the MOST appropriate course of action for this patient? A. Send the patient to the ED for further care B. Ask your manager to issue a refund on the defective inhaler C. Review inhaler technique, and if appropriate, call his MD recognizing the progressive nature of COPD and recommend the addition of a LAAC D. Review inhaler technique, and if appropriate, cal his MD recognizing - ANSWER - C. Review inhaler technique, and if appropriate, call his MD recognizing the progressive nature of COPD and recommend the addition of a LAAC Which of the following is/are appropriate intervention(s) for the treatment and/or prevention of COPD progression in a GOLD 2, Group B patient who smokes 2 packs daily? A. Initiating a LABA or LAAC
B. Ensuring appropriate inhaler technique C. Influenza vaccine and short-acting bronchodilator therapy D. Smoking cessation E. All of the above - ANSWER - E. All of the above A patient started on tiotropium therapy should be counseled about which of the following common side effects? A. Dry mouth and cough B. Tachycardia and palpitations C. Bad taste D. A and C only E. All of the above - ANSWER - D. A and C only BB is a 55 yof with a 40 pack year history of smoking. She reports to the Urgent Care today, secondary to an abrupt increase in dyspnea and mucus production. She states that over the past two days she has had increased difficulty performing daily tasks, and is coughing up very thick, clear sputum. SpO2 in the clinic is 89% and BB has had no change in mental status. Vitals and labs are WNL. Should BB be treated with antibiotics at this time? A. Yes, patient is feeling worse B. Yes, should cover for community acquired pneumonia C. No, patient lacks one of the "cardinal symptoms" necessary for abx use D. No, only hospitalized patients should be treated with abx - ANSWER - C. No, patient lacks one of the "cardinal symptoms" necessary for abx use (must be purulent sputum) Use of systemic corticosteroids is controversial in that they neither improve FEV1 nor decrease relapse rates in hospitalized patients with COPD exacerbations. A. True B. False - ANSWER - B. False (it improves in both) Very severe GOLD IV COPD MAY be characterized by which of the following? A. FEV1/FVC <70%, FEV1 <30% B. Respiratory failure and cor pulmonale C. Weight loss and audible wheeze D. Dyspnea and hypoxemia E. All of the above - ANSWER - E. All of the above Choose the statement that best describes the difference between ASTHMA and COPD? A. Asthma: Onset usually occurs in midlife, symptoms vary from day to day B. Asthma: Family history, long exposure to tobacco smoke, allergies often absent C. COPD: Slow progressive symptoms, dyspnea with exercise, onset at midlife D. COPD: Onset early in life, largely irreversible, several extrapulmonary effects E. Asthma and COPD: Because inflammation is prominent in both, steroids are very effective in both - ANSWER - C. COPD: Slow progressive symptoms, dyspnea with exercise, onset at midlife Which of the following medications has both anti- inflammatory and bronchodilator effects, improves FEV1, and reduces exacerbations in patients with stage III or IV COPD? A. Tiotropium B. Breo Ellipta C. Anoro Ellipta D. Roflumilast E. Indacaterol - ANSWER - D. Roflumilast