Pulmonary (NCCPA outline) (Latest 2023 / 2024) Actual Questions and Answers 100% Correct
- What is the best and most objective way to assess asthma exacerbation severity and patient
response in the ED?
Answer: Peak Expiratory Flow Rate
- What is the most common organism isolated on respiratory cultures in bacterial tracheitis?
Answer: Staph Aureus
- An O2 saturation of 90% corresponds to
Answer: RESPIRATORY DISTRESS
- Management for Intermittent Asthma
Answer: Inhaled SABA as needed
- Management for Mild Persistent Asthma
Answer: Inhaled SABA as needed + LOW DOSE ICS
- Management for Moderate Persistent Asthma
Answer:
- Low ICS + LABA OR
- Increased ICS dose OR
- Add LTRA
- Management for Severe Persistent Asthma
Answer: High dose ICS + LABA
+/- Omalizumab (Anti-IgE drug)
- IV magnesium can be useful in pts with asthma because it is...
Answer: a bronchodilator
9. 1st line treatment of acute asthmas: SABA
- albuterol, levalbuterol, terbutaline, epinephrine. MOA
Answer: bronchodialtors
- Besides Beta agonists, what else can be given in addition for acute asthma exacerbations?
Answer:
- *Anticholinergics (Atrovent)*: central bronchodilator; has a synergist response when added
to albuterol. Helpful in 1st hour.
- Corticosteroids (Prednisone): all but the mildest exacerbations should be dis- charged on a 1 / 2
short course of steroids unless CI.
- How do you manage long term, chronic asthma?
Answer:
- Maintenance includes
*Inhaled Corticosteroids (ICS)*: *TOC for longterm persistent asthma*
- LABAs: prophylaxis esp for nighttime; step down from LABA is recc after relief of
symptoms >3months.
3. Mast Cell Modifiers: best for cold air, exercise (Cromolyn, Nedocromil)
- Leukotriene Modifiers/ Receptor agonists (LTRAs): useful for asthmatics with allergic
rhinitis, aspirin induced asthma.
- Chronic Bronchitis ABG
Answer: Respiratory A*C*IDOSIS
C= chronic bronchtis
- Emphysema ABG
Answer: Respiratory Alkalosis
- How do you manage COPD
Answer:
1. SMOKING CESSATION
- Bronchodilators
- *Anticholinergic inhalers (ipratropium and tiotropium)*; preferred over beta agonists in COPD
- SABAs; for short term relief
- Theophylline (refractory)
- *Steroids for exacerbation*
4. *Supplemental O2* when sat is <88%; cor pulmonate, or PaO2 <55 OTHER:
Exercise Antibiotics when sic Vaccinations (pneumovax, flu) Pulm Rehab Surgery
- - Patient with a history of repeated respiratory tract infections
- Complaining of a cough with large amounts of mucopurulent, *foul-smelling sputum*
- PE will show crackles and wheezing on lung auscultation
- CXR will show dilated and thickened airways ("tram-tracks")
- / 2