COPD test questions

Question 1

VT

Answer 1

Normal or increase

Question 2

IRV

Answer 2

Normal or decrease

Question 3

ERV

Answer 3

Normal or decrease

Question 4

RV

Answer 4

Increase

Question 5

VC

Answer 5

Decrease

Question 6

IC

Answer 6

Normal or decrease

Question 7

FRC

Answer 7

Increase

Question 8

TLC

Answer 8

Normal or increase

Question 9

RV/TLC ratio

Answer 9

Normal or increase

Question 10

What emphysema is genetic or inherited?

Answer 10

Panlobular

Question 11

What emphysema results from cigarette smoking?

Answer 11

Centrilobular

Question 12

_____ is a preventable and treatable disease state characterized by airflow limitation that is not fully _____.

Answer 12

COPD; reversible

Question 13

_____ is defined clinically as a chronic productive cough for 3 months in each of 2 successive years in a patient in whom other causes of productive chronic cough have been excluded.

Answer 13

Chronic bronchitis

Question 14

____ is defined pathologically as the presence of permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.

Answer 14

Emphysema

Question 15

What is based on the major “clinical manifestations” associated with the disease?

Answer 15

Chronic bronchitis

Question 16

What is based on the pathology, or the “anatomic alterations of the lung,” associated with the disorder?

Answer 16

Emphysema

Question 17

_____ is a preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.

Answer 17

COPD

Question 18

What are some anatomic alterations of the lungs associated with chronic bronchitis?

Answer 18

Chronic inflammation, excessive mucus, mucus plugging, bronchospasm, hyperinflation/air trapping

Question 19

What are some anatomic alterations of the lungs associated with emphysema?

Answer 19

Permanent enlargement, destruction of pulmonary capillaries, weakening of the distal airways, hyperinflation/air trapping

Question 20

What are some considered risk factors for COPD?

Answer 20

Tobacco smoke, occupational dusts and chemicals, indoor/outdoor air pollution, conditions that affect normal lung grow and genetic predisposition (AAT deficiency)

Question 21

What are the key indicators for considering a COPD diagnosis?

Answer 21

Dyspnea, chronic cough, chronic sputum production, history of exposure to risk factors

Question 22

What are the 3 main spirometry tests for COPD?

Answer 22

FVC, FEV1, FEV1/FVC ratio

Question 23

The presence of COPD is confirmed with both the ____ and ____ are decreased

Answer 23

FEV1; FEV1/FVC ratio

Question 24

Stage I COPD

Answer 24

Mild; FEV1>=80%

Question 25

Stage II COPD

Answer 25

Moderate; FEV1 50% to <80% of predicted and patient often complains of shortness of breath upon exertion

Question 26

Stage III COPD

Answer 26

Severe; FEV1 30% to 50% impacts the quality of life

Question 27

Stage IV COPD

Answer 27

Very severe; FEV1 <50% of predicted, plus chronic respiratory failure

Question 28

Emphysema patients show a _____ body build and _____ where chronic bronchitis patients are ______.

Answer 28

Thin and barrel chest; stocky/overweight

Question 29

Emphysema patients tend to have respiratory patterns like ________ where as chronic bronchitis patients tend to have respiratory patterns like _____

Answer 29

Hyperventilation; hypoventilation

Question 30

Emphysema patients demonstrate ______ breathing while chronic bronchitis patients have a ____ and _____.

Answer 30

Pursed lip; cough and sputum

Question 31

Emphysema patients have _____ skin while chronic bronchitis patients show signs of ______, ______ and _______.

Answer 31

Reddish; cyanosis, peripheral edema and neck vein distention

Question 32

______ patients tend to use their accessory muscles when breathing

Answer 32

Emphysema

Question 33

______ has decreased breath/heart sounds, prolonged expiration, decreased diaphragmatic excursion and hyperresonance while ______ has wheezes, crackles and rhonchi depending on the severity of the disease

Answer 33

Emphysema; chronic bronchitis

Question 34

On a chest radiograph, _____ has hyperinflation, narrow mediastinum, normal or small vertical heart, low flat diaphragm and presence of blebs or bullae

Answer 34

Emphysema

Question 35

On a chest radiograph, ____ has congested lung fields, densities, increased bronchial vascular markings, and an enlarged horizontal heart

Answer 35

Chronic bronchitis

Question 36

Infections and polycythemia are commonly found in ____ patients

Answer 36

Chronic bronchitis

Question 37

A decrease in DLco and DLco/VA is commonly found in ____ patients

Answer 37

Emphysema

Question 38

What disease is associated with pulmonary hypertension and cor pulmonale?

Answer 38

Chronic bronchitis

Question 39

Altered sensorium such as anxiety and irritability are often found in _____ patients

Answer 39

Emphysema (severe stage) and chronic bronchitis (moderate and severe stage)

Question 40

Digital clubbing is often found in ____ patients

Answer 40

Late stage emphysema and chronic bronchitis

Question 41

Hoover's sign is associated with what disease?

Answer 41

Emphysema (severe stage)

Question 42

Upon palpation of the chest, decreased tactile fremitus, decreased chest expansion and PMI shifts to the epigastric area is often signs of what?

Answer 42

Emphysema

Question 43

What is a normal ABG for a CO2 retained at equilibrium?

Answer 43

``` pH 7.38 SpO2 88-90 PaCO2 60 PaO2 58 HCO3 34 ```

Question 44

What are the ABG results for acute alveolar hyperinflation superimposed on chronic ventilatory failure?

Answer 44

pH 7.48 PaCO2 48 PaO2 38 HCO3 34

Question 45

_____ is the dilation of the bronchi and bronchioles, which is chronic in nature and results in inflammation and damage to the walls of these airways

Answer 45

Bronchiectasis

Question 46

What blood gas changes are associated with bronchiectasis?

Answer 46

Respiratory alkalosis with hypoxemia (acute alveolar hyperinflation) or in severe cases respiratory acidosis with hypoxemia (chronic alveolar hypoinflation)

Question 47

_____ and ______ decrease in pulmonary function studies of bronchiectasis

Answer 47

Airflows and vital capacity

Question 48

What feature favors the diagnosis of COPD?

Answer 48

Chronic daily phlegm production

Question 49

Cough, phlegm production, wheezing and shortness of breath are common signs and symptoms of _____

Answer 49

COPD

Question 50

What are the four clinical goals for managing stable COPD?

Answer 50

- Establish diagnosis - Prolong survival - Simplify medical regimen - Optimize lung function - Maximize patient's functional status

Question 51

Both _____ and _____ bronchodilators can improve airflow in patients with COPD

Answer 51

Anticholinergic and adrenergic

Question 52

Other treatment options to maximize lung function include administering _____ and methylxanthines

Answer 52

Corticosteroids

Question 53

Systemic corticosteroids can produce significant improvements in airflow in _____ of patients with stable COPD

Answer 53

6%-29%

Question 54

Controlled trials do show lessened dyspnea in _____ recipients despite lack of measurable increases in airflow

Answer 54

Methylxanthines

Question 55

To minimize the chance of toxicity, current recommendations suggest maintaining serum theophylline levels at _____

Answer 55

8-10 mcg/ml

Question 56

What can be done to prevent the progression of COPD?

Answer 56

Cessation of smoking

Question 57

What therapy has been proven to prolong the survival of COPD patients?

Answer 57

Supplemental oxygen

Question 58

PaO2 <= 55mmHg, PaO2 56-59mmHg or SaO2 89% signifies the need for _____

Answer 58

Continuous oxygen therapy

Question 59

What are two surgeries that can be used in extreme cases for patient's with end stage COPD?

Answer 59

Lung transplantation or lung volume reduction surgery (LVRS)

Question 60

Can all patients benefit from LVRS?

Answer 60

No, patients with severe COPD should not get it

Question 61

___ of patients can be expected to live for five years after receiving a lung transplant surgery

Answer 61

54%