Week 4 - Introduction to the treatment of Respiratory Diseases

Question 1

Which of the following is an obstructive lung disease?
A) Pulmonary fibrosis
B) Asthma
C) Sarcoidosis
D) Pleural effusion

Answer 1

Correct Answer: B) Asthma

Question 2

Which condition is characterized by largely irreversible airflow obstruction?
A) Asthma
B) COPD
C) Tuberculosis
D) Pneumonia

Answer 2

Correct Answer: B) COPD

Question 3

Which of the following is a short-acting β2 agonist?
A) Salmeterol
B) Ipratropium
C) Salbutamol
D) Tiotropium

Answer 3

Correct Answer: C) Salbutamol

Question 4

Which drug class is used for long-term asthma control?
A) SABA
B) ICS
C) SAMA
D) Theophylline

Answer 4

Correct Answer: B) ICS

Question 5

What is the main side effect of β2 agonists?
A) Bradycardia
B) Tremor
C) Hypertension
D) Fatigue

Answer 5

Correct Answer: B) Tremor

Question 6

Which therapy reduces exacerbations but does NOT prevent disease progression in COPD?
A) LABA
B) ICS
C) LAMA
D) All of the above

Answer 6

Correct Answer: D) All of the above

Question 7

What is the main long-term therapy for severe COPD?
A) Oral corticosteroids
B) Short-acting bronchodilators
C) Long-term oxygen therapy (LTOT)
D) Montelukast

Answer 7

Correct Answer: C) Long-term oxygen therapy (LTOT)

Question 8

Which of the following is NOT one of the “5 A’s” for smoking cessation?
A) Ask
B) Assist
C) Arrange
D) Administer

Answer 8

Correct Answer: D) Administer

Question 9

Which medication is used for smoking cessation?
A) Varenicline
B) Theophylline
C) Montelukast
D) Salbutamol

Answer 9

Correct Answer: A) Varenicline

Question 10

What does spirometry measure in respiratory diseases?
A) Oxygen saturation
B) Airflow limitation
C) Blood pressure
D) Lung compliance

Answer 10

Correct Answer: B) Airflow limitation

Question 11

Which of the following is a key characteristic of obstructive lung disease?
A) Difficulty inhaling
B) Difficulty exhaling
C) Reduced lung volumes
D) Normal lung function

Answer 11

Correct Answer: B) Difficulty exhaling

Question 12

Which condition is primarily restrictive rather than obstructive?
A) Asthma
B) COPD
C) Pulmonary fibrosis
D) Chronic bronchitis

Answer 12

Correct Answer: C) Pulmonary fibrosis

Question 13

What is the primary feature of asthma?
A) Irreversible airway obstruction
B) Reversible airway obstruction
C) Pulmonary fibrosis
D) Absence of inflammation

Answer 13

Correct Answer: B) Reversible airway obstruction

Question 14

What is a key component of airway remodeling in asthma?
A) Loss of alveoli
B) Bronchial smooth muscle hypertrophy
C) Increased surfactant production
D) Increased alveolar elasticity

Answer 14

Correct Answer: B) Bronchial smooth muscle hypertrophy

Question 15

Which of the following is a short-acting β2-agonist (SABA)?
A) Salmeterol
B) Salbutamol
C) Tiotropium
D) Montelukast

Answer 15

Correct Answer: B) Salbutamol

Question 16

Which of the following is a long-acting β2-agonist (LABA)?
A) Ipratropium
B) Salmeterol
C) Theophylline
D) Fluticasone

Answer 16

Correct Answer: B) Salmeterol

Question 17

Which type of medication is Montelukast?
A) Anticholinergic agent
B) β2 agonist
C) Leukotriene receptor antagonist
D) Corticosteroid

Answer 17

Correct Answer: C) Leukotriene receptor antagonist

Question 18

Which drug class is primarily responsible for reducing inflammation in asthma?
A) β2 agonists
B) Corticosteroids
C) Anticholinergics
D) Xanthines

Answer 18

Correct Answer: B) Corticosteroids

Question 19

What is the main side effect of β2-agonists?
A) Bradycardia
B) Tremor
C) Hypoglycemia
D) Nausea

Answer 19

Correct Answer: B) Tremor

Question 20

Which of the following is an anti-IgE therapy for severe asthma?
A) Mepolizumab
B) Benralizumab
C) Omalizumab
D) Dupilumab

Answer 20

Correct Answer: C) Omalizumab

Question 21

What interleukin does Mepolizumab target?
A) IL-4
B) IL-5
C) IL-6
D) IL-13

Answer 21

Correct Answer: B) IL-5

Question 22

Which of the following biologics is an anti-IL-4/IL-13 therapy?
A) Tezepelumab
B) Dupilumab
C) Fasenra
D) Montelukast

Answer 22

Correct Answer: B) Dupilumab

Question 23

What is a key difference between asthma and COPD?
A) Asthma is reversible, COPD is largely irreversible
B) COPD affects children more than asthma
C) COPD is an autoimmune disease
D) Asthma does not involve inflammation

Answer 23

Correct Answer: A) Asthma is reversible, COPD is largely irreversible

Question 24

Which of the following is the best initial treatment for COPD?
A) Short-acting bronchodilators (SABA or SAMA)
B) Long-acting β2 agonists (LABA)
C) Systemic corticosteroids
D) Anti-IgE therapy

Answer 24

Correct Answer: A) Short-acting bronchodilators (SABA or SAMA)

Question 25

What is the major risk factor for COPD? A) Air pollution B) Smoking C) Genetic mutations D) Obesity

Answer 25

Correct Answer: B) Smoking

Question 26

What is the mechanism of CFTR modulators like Orkambi? A) Increase mucus production B) Improve chloride ion transport C) Reduce surfactant production D) Block airway remodeling

Answer 26

Correct Answer: B) Improve chloride ion transport

Question 27

Which CFTR modulator was introduced in 2023? A) Kaftrio B) Orkambi C) Symkevi D) Tezspire

Answer 27

Correct Answer: A) Kaftrio

Question 28

What is the epithelium of the respiratory tract

Question 29

asthma can be defined by bronchial _______ reactivity

Answer 29

hyper

Question 30

Glucocorticoids are used to treat asthma, physiologically what do they do?

Answer 30

Modulates TH2 response inhibit Il-4, Il-5, IL - 13 usually these activated B cells and eosinophils

Question 31

Beta 2 adrenergic agonists are used to dilate the bronchi, they also stabilise cells, what cells are these?

Answer 31

Mast cells monocytes cilia

Question 32

name some steroids which are used to treat asthma

Answer 32

Beclomethasone Budesonide Fluticasone Prednisolone Hydrocortisone

Question 33

what cells do the steroids in asthma treatment decrease

Answer 33

Decrease Th2 cytokines

Question 34

Way are the 5 A's to smoking cessation (brief interventions

Answer 34

Ask Advise Assess Assist Arrange

Question 35

what are NANC nerves

Answer 35

Non-noradrenergic, non-cholinergic transmitter A non-noradrenergic, non-cholinergic transmitter is a neurotransmitter of the enteric nervous system that is neither acetylcholine, norepinephrine, nor epinephrine.

Question 36

what is the neurotransmitter released from the post ganglion of the Vagus nerve, and where does it bind to

Answer 36

ACh Muscarinic receptors I and III

Question 37

What is PCD

Answer 37

primary ciliary diskenesia defective movement of these cilia if the periciliary fluid not there then the cilia do not beat

Question 38

What is Cystic Fibrosis

Answer 38

Failure of the CFTR channel chloride ion channel

Question 39

What cranial nerve is the Vagus Nerve

Answer 39

X

Question 40

what is the parasympathetic nervous system also known as

Answer 40

cholinergic

Question 41

What does parasympathetic nervous system do to smooth muscle cells

Answer 41

contract the smooth muscle cells

Question 42

What is used to block the response of the parasympathetic nervous system on the muscraninc receptors on the smooth muscle cells

Answer 42

Ipratropium bromide

Question 43

where do the NANC nerves act (NO)

Answer 43

guanylyl cyclase

Question 44

bronchoconstriction of the airways is common in what conditions

Answer 44

Asthma and COPD

Question 45

why is bronchoconstriction (even if small) dangerous

Answer 45

As the radius in the airways gets smaller it contributes even greater as radius is calculated by R^4

Question 46

Interpreting a Spirometry graph, rank in a descending order what is expected in the volume (L) expired graph

Answer 46

Normal Obstructive restrictive Severe Obstruction

Question 47

interpreting a spirometry graph, what would an example of a server obstruction be (condition)

Answer 47

Emphysema

Question 48

interpreting a spirometry graph, what would an example of a restrictive condition be, nothing wrong with the airways

Answer 48

Pulmonary Fibrosis MND - motor neuron disease Kyphoscoiliosis

Question 49

Try define asthma

Answer 49

recurrent, reversible, airflow obstruction

Question 50

What are some symptoms of asthma

Answer 50

wheezing, cough, hyperinflation bronchial hyper-reactivity - when you respond to an irritant molecule more quickly and with hyper sensitivity

Question 51

What is FVC (spirometry

Answer 51

Forced Vital Capacity

Question 52

what are the two phases of of asthma

Answer 52

Early phase: bronchospasm (0-3 hours) Late Phase: Inflammation (4-8 hours)

Question 53

How does the T cell response differ in people with asthma and "normal people"

Answer 53

there is a Th2 response (normally used for parasitic responses) Th2 activates Eosinophils and mast cells through activation. of the IgE antibodies Normally only Th1 is activated, doesn't induce the asthmatic response

Question 54

name some epithelial changes in people with asthma

Answer 54

Mucous gland hyper secretion Leaking blood vessels exposed nerves sensitive to kinins - due to epithelial shedding smooth muscle constriction

Question 55

what are the 4 bronchodilators

Answer 55

Beta 2 adrenergic agonists Anticholinergic agents Leukotriene antagonists Xanthines

Question 56

what are the associated problems with Beta 2 adrenoreceptor agonists

Answer 56

Tremor is the principle side effect Tolerance can occur some concerns regarding excess mortality

Question 57

What is an example of anticholinergic agents (short acting)

Answer 57

Ipatropium

Question 58

What is an example of anticholinergic agents (long acting)

Answer 58

Tiotropium

Question 59

What is an example of anticholinergic agents (antisecretory)

Answer 59

Bronchodilate

Question 60

Beta 2 adrenoreceptors agonists - what are the two long acting beta agonists and which one can't be used as a reliever as it takes too long to get a response

Answer 60

Salmeterol - takes too long to achieve a response formoterol !!

Question 61

what are the anti inflammatory agents for asthma

Answer 61

steroids Leukotriene antagonists Biologics - biological ways of affecting the anti inflammatory pathway

Question 62

what is the MOA of steroids

Answer 62

Intracellular receptor inducing an intranuclear action by following binding they induce a conformation change in the receptor, the receptor translocates to the nucleus and binds to the DNA, induces transcription, translation, of mediator proteins and these are released

Question 63

what are the new guidelines for asthma therapy

Answer 63

Regularly inhaled steroid +/- LABA As when required use of Beta 2 agonist

Question 64

what does MART stand for

Answer 64

Maintenance and reliever treatment

Question 65

What does mart contain

Answer 65

formoterol and steroids - treatment for relief and anti inflammatory effects

Question 66

what are the 2 examples of anti interleukins

Answer 66

Mepolizumab Benralizumab

Question 67

explain COPD progression

Answer 67

Cigarette smoke -> alveolar macrophage and Epithelial cell activation activates CD8(Tc1) and neutrophils heading to small airway narrowing and alveolar destruction

Question 68

COPD - Asthma reversible?

Answer 68

COPD is irreversible Asthma is reversible

Question 69

In COPD does drug therapy prevent disease progression

Answer 69

No

Question 70

In COPD does drug therapy improve symptoms?

Answer 70

Yes and exacerbations may be reduced

Question 71

What is COPD treated with

Answer 71

LAMA and LABA

Question 72

What does COPD stand for

Answer 72

Chronic obstructive Pulmonary Disease

Question 73

what percent of heavy smokers get COPD

Answer 73

8%