CMN 568 - UNIT 3: ASTHMA QUESTIONS WITH VERIFIED ANSWERS | COMPLETE SET

CMN 568 - UNIT 3: ASTHMA QUESTIONS WITH VERIFIED ANSWERS | COMPLETE SET The strongest identifiable predisposing factor for the development of asthma is _________, but obesity is increasingly recognized as a risk factor. - ANSWER Atopy A syndrome characterized by a tendency to be "hyperallergic". (papa 243) Essentials of Asthma Diagnosis: - Episodic or chronic symptoms of airflow obstruction. - Reversibility of airflow obstruction, either spontaneously or following bronchodilator therapy. - Symptoms frequently worse at night or in the early morning. - Prolonged expiration and diffuse wheezes on physical exam. - Limitation of airflow on pulmonary function testing or positive bronchoprovocation challenge. - ANSWER ... Which of the following findings on physical exam increase the probability of asthma? a. nasal mucosal swelling b. increased nasal secretions c. nasal polyps d. all of the above - ANSWER d. all of the above All are often seen in pts with allergic asthma. (papa 246) True or False: Wheezing during forced expiration correlates well with the presence of air flow obstruction. - ANSWER False: Wheezing during normal breathing correlates well with the presence of air flow obstruction, not during forced expiration. (papa 246) What findings on an ABG may indicate impending respiratory failure of an asthmatic pt and need for mechanical ventilation? a. Decreased PaCO2 and respiratory acidosis. b. Increased PaCO2 and respiratory acidosis. c. Increased PaCO2 and respiratory alkalosis. d. Decreased PaCO2 and respiratory alkalosis. - ANSWER b. Increased PaCO2 and respiratory acidosis. (papa 246) During a PFT, a patient inhales methacholine causing a ≥ 20% decrease in his FEV1. Is this a positive or negative test, and what is the test called? a. negative methacholine test of bronchial provocation. b. positive bronchial provocation c. positive methacholine test of bronchial provocation. d. none of the above - ANSWER c. Positive methacholine test of bronchial provocation. A negative test has a negative predictive value of asthma of 95%. (papa 247) When instructing your patient on how to use the PEF meter to monitor asthma control, when do you tell him to use it for the most accurate measurements? a. After morning bronchodilator dose and before dinner. b. As soon as he wakes up after bronchodilator and right before he goes to bed. c. As soon as he wakes up before bronchodilator and early afternoon after bronchodilator. d. Directly after morning bronchodilator dose and then again directly after lunchtime bronchodilator dose. - ANSWER c. As soon as he wakes up before bronchodilator and early afternoon after bronchodilator. PEF is generally lowest on first awakening and highest several hours before the midpoint of the waking day. A 20% change in PEF values from morning to afternoon suggests inadequately controlled asthma. (papa 247) When considering the differential diagnosis of asthma, what lower airway disorder can mimic asthma in patients who have atypical symptoms or poor response to therapy? a. laryngotracheal masses b. bronchiolitis obliterans c. churg-strauss syndrome d. episodic laryngeal dyskinesis. - ANSWER b. bronchiolitis obliterans All answers are considered in the differential diagnosis, but are not lower airway disorders. Other lower airway disorders that can mimic asthma include COPD, bronchiectasis, allergic bronchopulmonary mycosis, CF, and eosinophilic pneumonia. (papa 248)