Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Family Medicine Clerkship > Pulmonary Disorders > Flashcards

Pulmonary Disorders Flashcards

1
Q

One in __ children have asthma

A

14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some precipitating or aggravating factors for asthma?

A 
URIs
exercise
drugs (ASA, BB)
weather changes
allergens
emotional expression
food additives
exposure to allergens or irritants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the four pathophysiological characteristics of asthma acutely?

A
  1. bronchoconstriction
  2. airway hyperresponsiveness
  3. airway edema
  4. increased mucous secretion

(and inflammation from all three)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 5 pathophysiological characteristics of asthma chronically?

A
  1. fibrosis
  2. mucous hypersecretion
  3. smooth muscle hypertrophy
  4. angiogenesis
  5. loss of reversibility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 5 questions generally included in the Asthma Control Test?

A
  1. How often does your asthma keep you from getting things done?
  2. How often do you have SOB?
  3. How often do you symptoms wake you up at night?
  4. How often do you use your rescue inhaler?
  5. How would you rate your asthma control in the past 4 weeks?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the typical PFT findings for a diagnosis of asthma.

A

Obstructive picture (decreased FEV1)

12% of 200 mL improvement in FEV1 with a bronchodilator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the FEV1 in mild asthma?

A

> 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the FEV1 range for moderate asthma?

A

60-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the FEV1 range for severe asthma?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the three general things we base asthma severity classification on?

A
  1. frequency of symptoms (ACT)
  2. FEV1
  3. # of exacerbations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the classification rules based on symptoms?

A

intermittent: less than 2 days/week
mild: more than 2 days/week
moderate: daily
severe: throughout the day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the classification rules based on how often they use their inhaler?

A

intermittent: less than 2x/month
mild: 3-4x/mo
moderate: >1x/wk but not daily
severe: often 7x/week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the classification rules based on interference with normal activity?

A

intermittent: none
mild: minor limitation
moderate: some limitation
severe: extremely limited

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the classification rules based on number of exacerbations?

A

if only 0-1/yr, then it’s only intermittent

anything 2 or more can be mild, moderate or severe depending on other categories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the main rescue medication for asthma?

A

short acting beta2 agonists (SABA)

albuterol or levalbuterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the three main classes of controller medications for asthma?

A

inhaled corticosteroids

leukotriene modifiers

long acting beta2 agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the examples of leukotriene modifiers?

A

montelukast (singulair)
zafirlukast
zileuton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the examples of LABAs?

A

salmeterol
formoterol
vilanterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

True or false: you cannot use LABAS as monotherapy in asthma.

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the four main combination ICS/LABA inhalers?

A

advair (fluticasone/salmeterol)

sumbicort (budesonide/formoterol)

Dulera (mometasone/formoterol)

Breo (fluticasone/vilanterol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the immunomodulator that can be used for asthma (dose/frequency determined by IgE levels)?

A

omalizumab (xolair)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do mepolizumab and reslizumab work?

A

interleukin-5 antagonists

can be used as add-on maintenance therapy in severe asthma in adults and adolescents with eosinophilic phenotype

23
Q

What is the management strategy for intermittent asthma?

24
Q

What is the preferred step 2 management for asthma (for mild persistent)?

A

SABA prn and low dose ICS

25
What is the preferred step 3 management for moderate persistent asthma?
SABA prn low dose ICS + LABA or Medium dose ICS
26
What is the preferred step 4 management for moderate or severe persistent asthma?
SABA prn moderate dose ICS +LABA
27
What is step 5 for severe persistent asthma?
SABA prn Higher dose ICS LABA + consider omalizumab if allergic
28
What is step 6?
SABA prn High dose LABA oral corticosteroids +consider omalizumab
29
COPD is the ___ leading cause of death.
5th
30
What aren
``` SMOKING occupation dust and chemicals second hand smoke indoor\outdoor pollution family history low socioeconomic status ```
31
What are the three main symptoms of COPD?
dyspnea chronic cough chronic sputum production
32
The CAT is the main questionnaire to assess COPD symptoms. What score would make you worried for more COPD symptoms?
>10
33
What diagnostic test is required to make the diagnosis of COPD?
PFTs
34
What is the spirometry result for a COPD diagnosis?
post-bronchodilator FEV1/FVC
35
What is the FEV1 cutoff for mild COPD?
> or equal to 80%
36
What range of FEV1 for moderate COPD?
50 to 80%
37
What range for severe COPD?
30 to 50%
38
What range for very severe?
less than 30%
39
What are the three things that would make a patient at high risk for COPD exacerbation?
hx of 2+ exacerbations in the past year FEV1
40
True or false; medication management has been shown to improve mortality and slow the long-term decline in lung function.
false - they don't :( they just provide symptomatic treatment
41
What is the initial treatment in COPD? (unlike asthma...)
LABAs or LAMA or a combination | short acting is only prn
42
In moderate to severe COPD, which is preferred: SABAs or SAMAs?
SAMA | and SAMA?SABA combo is preferred over SABA alone
43
What is the main oral phosphodiesterase-4 inhibitor for COPD?
roflumilast
44
What COPD patients will have the most benefit from roflumilast?
those with a major chronic bronchitis component
45
Which antibiotic has been found to be useful for prevention of COPD exacerbations?
Azithromycin
46
What is the typical management for COPD exacerbations when they occur/
short-acting albuterol nebulizer every 1-4 hours (or short acting ipratropium...or duoneb to make it easy) with systemic corticosteroids (40 mg prednisone qd for 5 days) and sometimes antibiotics
47
When should antibiotics be used for exacerbation?
when you have all three cardinal symptoms (increased dyspnea, sputum increase, or sputum purulence) or with only two if one of them is increased sputum purulence or if exacerbation is so severe that it requires mechanical ventilation
48
What antibiotics are preferred for uncomplicated COPD?
``` azithro clarithro doxy bactrim amoxicillin ```
49
What antibiotic is preferred for complicated COPD with risk factors?
amox/clav levo moxi
50
What antibiotic should you use if you're worried about pseudomonas infection?
high dose levo or cipro
51
If someone has the asthma, COPD combo, what is the best treatment?
ICS and LABA combo
52
But if there are any features more consistent with asthma, what don't you use?
LABA monotherapy
53
What don't you use if there are features more consistent with COPD?
no ICS monotherapy

Family Medicine Clerkship (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions