COPD

Question 1

How is COPD characterized?

Answer 1

Persistent respiratory symptoms like dyspnea, cough, sputum production, and or exacerbation, and airflow limitation

Question 2

What is the main risk factors of COpd?

Answer 2

Smoking, rare genetic variants, abnormal lung development, and accelerated lung aging

Question 3

What are symptoms in COPD caused by?

Answer 3

Airway alveolar abnormalities usually caused by exposure to noxious particles or gas

Question 4

Which airflow obstruction type results from small airway disease

Answer 4

Obstructive bronchiololitis

Question 5

Which airflow disease results from lung tissue destruction

Answer 5

Emphysema

Question 6

What are important risk factors of COPD

Answer 6

Socioeconomic factors, occupation, genetic variants (alpha 1 antitrypsin deficiency)

Question 7

What are environmental risk factors of COPD?

Answer 7

Indoor wood burning, animal dung, and crop residues, and coal

Question 8

How is COPD characterized?

Answer 8

Non reversible airflow limitation

Question 9

What level of FEV1 and FVC confirms the presence of persistent airflow limitations

Answer 9

< 0.70

Question 10

What is the key symptom of exacerbation?

Answer 10

Increased dyspnea

Question 11

Which four parameters are used to assess pharmacological needs for COPD

Answer 11

1. Severity of airflow limitation
2. Nature and magnitude of current symptoms
3. Previous history of moderate to severe exacerbations
4. Presence and type of other diseases

Question 12

What is GOLD category 1

Answer 12

Mild, FEV > 80% predicted

Question 13

What is GOLD 2

Answer 13

Moderate, 50< FEV AND < 80 % predicted

Question 14

What is GOLD 3 level

Answer 14

Severe 30% < FEV ABD < 50% predicted

Question 15

What is GOLD level 4

Answer 15

Very severe
FEV <30% predicted

Question 16

What assessment test is used to predict the extent and health status of COPD

Answer 16

CAT

Question 17

What is the GOLD ABE assessment tool

Answer 17

A tool that measures the clinical significance of COPD with the assessment of airflow obstruction

Question 18

How is group A categorized?

Answer 18

Less symptomatic and low risk of future exacerbations
MMRC grade 0 to 1 or CAT score < 10

Question 19

How is group B categorized

Answer 19

More symptomatic with a low risk of future exacerbations

MMRC grade >2 or CAT score >10

Question 20

How is group E categorized

Answer 20

High risk of future exacerbations with > 2 exacerbations per year or > 1 hospitalization for exacerbation

Question 21

What is the additional step to be placed in group E?

Answer 21

Patients who eosinophils are > 300

Question 22

What is the preferred treatment for Group A?

Answer 22

A bronchodilator (SABA or LABA) LABA is preferred only they have very occasional dyspnea

Question 23

What is the preferred treatment for Group B?

Answer 23

LABA + LAMA combination

Question 24

What is the preferred treatment for group E?

Answer 24

Combo of LABA + LAMA. Consider ICS if eosinophils are > 300 or if they have concomitant asthma

Question 25

What is the first line treatment for COPD?

Answer 25

Anticholinergic antimuscarinics

Question 26

What are the available anti muscarnics?

Answer 26

Ipratropium, tiotfopium, aclidinium, umeclidinum, glycopyrrolate

Question 27

What is the short acting anti-muscarinic used in COPD

Answer 27

Ipratropium

Question 28

What is the long acting antimuscarinic used in COpd

Answer 28

Tiotropium

Question 29

Which antimuscarinic anticholinergic has fewer side effects

Answer 29

Aclidinium bromide

Question 30

Which anticholinergic antimuscarinic is it fast acting effective option for patients with moderate to severe COPD

Answer 30

Glycopyrrolate

Question 31

What are the adverse effects of antimuscarinic anticholinergic agents?

Answer 31

Dry mouth, irrigation of the pharynx, headache

Question 32

What is the new triple therapy drugs for COPD?

Answer 32

ICS/ LAMA / LABA

Question 33

What is the PPD 4 inhibitor used for COPD

Answer 33

Roflumilast

Question 34

If eosinophils are less than 100 what should you treat COPD with?

Answer 34

Add roflumilast or azithromyocin

Question 35

What are the goals of COPD treatment?

Answer 35

Individualized, encourage smoking cessation, reduce symptoms and risk of exacerbations

Question 36

What are the symptoms of allergic rhinitis

Answer 36

Sneezing, rhinorhea, pruritis, nasal congestion, eye symptoms

Question 37

What is allergic. Rhinitis mediated by?

Answer 37

IgE

Question 38

What are the first like drugs for allergic rhinitis

Answer 38

Oral antihistamines like 1st gen- diphenhydramine, chlorpeniramine, clemastime, and hydroxyzine Or 2nd gen- cetrizine, levocetrizine, loratidine, desloratdine, fexofenadine

Question 39

Intranasal corticosteroids

Answer 39

Fluticasone, flunisolide, beclmethasone, mometsaone, ciclesonide

Question 40

Oral decongestants for rhinitis

Answer 40

Pseudophedrine , phenylphrine

Question 41

What are the opioid and non opioid antitussives used for cough?

Answer 41

Opioid- codeine and hydrocodome Nonopoid- dextromethrophan

Question 42

What age groups are antitussives not recommended in

Answer 42

Age 5 and younger

Question 43

What are the guidelines for an acute cough lasting fewer than three weeks and associated with the common cold?

Answer 43

Antihistamine and a decongestant

Question 44

What can be used to break up mucus and patients with their productive cough associated with an acute URI

Answer 44

Guaifenesin

Question 45

What drug should you not use for chronic cough associated with asthma or emphysema?

Answer 45

Guaifenesin