Deck 11: Corticosteroids in Respiratory Care

Question 1

Use of systemic corticosteroids may cause which of the following side effects?
1)Fluid retention
2)Increased white blood cell count
3)HPA suppression
4)Increased endogenous steroid production

A)1 and 4 only
B)1,2,and 4 only
C)2 and 4 only
D)1,2,and 3 only

Answer 1

1,2,and 3 only

Question 2

Corticosteroids are used with asthmatics and patients with chronic obstructive pulmonary disease (COPD)to achieve which effect?

A)Antiinflammatory
B)Breakdown of secretions
C)Reduced surface tension
D)Immunosuppression

Answer 2

Antiinflammatory

Question 3

A patient has been taking oral prednisone for 1 week following a severe episode of asthma.The physician decides to switch the patient to aerosolized beclomethasone (Qvar).What is the best way to accomplish this?

A)Stop the oral drug and begin the aerosol
B)Begin the aerosol and gradually taper off of the oral dose
C)Keep the patient on the full-strength oral dose,and add the aerosol as well for stronger results
D)You cannot stop oral steroids once they are begun

Answer 3

Begin the aerosol and gradually taper off of the oral dose

Question 4

The early phase of an asthmatic reaction occurs during what time frame?

A)15 minutes to 1 hour
B)2-4 hours
C)6-8 hours
D)24 hours

Question 5

Corticosteroids normally produced by the body are known as

A)endogenous.
B)exogenous.
C)extrinsic.
D)intrinsic.

Question 6

The inflammatory process includes which of the following activities?
1)Mediator cascade
2)Increased vascular permeability
3)Leukocytic infiltration
4)Phagocytosis

A)1 and 2 only
B)2 and 3 only
C)1,2,and 4 only
D)1,2,3,and 4

Question 7

Use of oral steroids for long periods can cause

A)HPA suppression.
B)increased adrenal cortex activity.
C)bronchospasm.
D)increased ACTH levels.

Question 8

Which of the following is produced in the hypothalamus?

A)Glucocorticoids
B)Corticotropin-releasing factor
C)Mineralocorticoids
D)Sex hormones

Question 9

The major cells responsible for an inflammatory response in asthma are

A)macrophages and mast cells.
B)mast cells and eosinophils.
C)T lymphocytes and macrophages.
D)basophils and SRS-A.

Question 10

Which of the following is a common side effect of inhaled corticosteroids?

A)Tachycardia
B)Bradycardia
C)Oral candidiasis
D)Immunosuppression

Question 11

The rise and fall of levels of glucocorticoids in the body follow what kind of rhythm?

A)Weekly
B)Monthly
C)Circadian
D)No set rhythm

Question 12

Side effects of systemic steroid treatment include which of the following?
1)HPA suppression
2)Cough
3)Dysphonia
4)Psychiatric reactions

A)1 and 4 only
B)2 and 3 only
C)1,2,and 3 only
D)1,2,3,and 4

Question 13

Corticosteroids are available for use in the United States in which of the following dosage forms?

A)DPI
B)MDI
C)Nebulizer solution
D)All of the above

Question 14

In chronic obstructive pulmonary disease (COPD),the primary inflammatory cells are

A)eosinophils.
B)T lymphocytes.
C)macrophages.
D)neutrophils.

Question 15

A patient complains of oral thrush and hoarseness since she has been using fluticasone by MDI.The physician asks you to make a suggestion to help her without discontinuing the drug.You suggest

A)inhale with a higher inspiratory flow rate.
B)switch to a DPI.
C)add a spacer and rinse the mouth after use.
D)pause 5 minutes between puffs.

Question 16

Which of the following are side effects of aerosolized steroid use?
1)Cough
2)Osteoporosis
3)Dysphonia
4)Oral thrush

A)1 and 2
B)1,3,and 4
C)2,3,and 4
D)all of the above

Question 17

The product combining an inhaled steroid and a bronchodilator is

A)dulera.
B)flovent.
C)fluticasone.
D)qvar.

Question 18

The steroids responsible for secondary male sex characteristics are known as

A)glucocorticoids.
B)mineralocorticoids.
C)androgenic.
D)exogenous.

Question 19

A significant side effect of corticosteroid use is inhibition of

A)IgE.
B)PDE.
C)HPA axis.
D)SRS-A.

Question 20

Which of the following are examples of steroids or steroid combinations available for inhalation?
1)AeroSpan
2)Flovent
3)Qvar
4)Advair

A)1,2,and 3 only
B)1 and 2 only
C)2 and 3 only
D)1,2,3,and 4

Question 21

What is the generic name of QVAR?

A)Beclomethasone dipropionate HFA
B)Fluticasone propionate
C)Mometasone furoate
D)Flunisolide hemihydrate HFA

Question 22

Causes of airway inflammation include which of the following?
1)HPA suppression
2)Trauma
3)Chronic bronchitis
4)Asthma

A)1 and 4 only
B)3 and 4 only
C)2,3,and 4 only
D)1,2,3,and 4

Question 23

What is the generic name of AeroSpan?

A)Beclomethasone dipropionate HFA
B)Fluticasone propionate
C)Mometasone furoate
D)Flunisolide hemihydrate HFA

Question 24

Your patient has an elevated white blood cell (WBC)count but no signs or symptoms of infection.She uses albuterol and salmeterol and is currently taking a glucocorticoid.What is the most likely cause of her elevated WBC count?

A)Albuterol
B)Salmeterol metered dose inhaler
C)Glucocorticoid
D)None of the above

Question 25

What is the generic name of Advair HFA?

A)Budesonide/formoterol fumarate HFA
B)Fluticasone propionate/salmeterol
C)Mometasone furoate/formoterol fumarate HFA
D)Beclomethasone/formoterol fumarate HFA

Question 26

Beneficial effects of glucocorticoids on $\beta$ -adrenergic receptors include

A)restoration of responsiveness.
B)increase in the number of $\beta$ receptors on the cell surface.
C)increasing affinity of the receptor for $\beta$ agonists.
D)all of the above.

Question 27

What is the generic name of Symbicort?

A)Budesonide/formoterol fumarate HFA
B)Fluticasone propionate/salmeterol
C)Mometasone furoate/formoterol fumarate HFA
D)Beclomethasone/formoterol fumarate HFA

Question 28

What is the generic name of Asmanex HFA?

A)Fluticasone propionate
B)Mometasone furoate
C)Flunisolide hemihydrate HFA
D)Budesonide

Question 29

What is the generic name of Pulmicort?

A)Fluticasone propionate
B)Mometasone furoate
C)Flunisolide hemihydrate HFA
D)Budesonide

Question 30

What is the generic name of Dulera?

A)Budesonide/formoterol fumarate HFA
B)Fluticasone propionate/salmeterol
C)Mometasone furoate/formoterol fumarate HFA
D)Beclomethasone/formoterol fumarate HFA

Question 31

What is the generic name of Flovent HFA?

A)Beclomethasone dipropionate HFA
B)Fluticasone propionate
C)Mometasone furoate
D)Flunisolide hemihydrate HFA

Question 32

Your patient tells you that she is having chest tightness and wheezing four to six times per week,plus she wakes up with chest tightness and wheezing about once per week.She uses albuterol each time,with relief.She is taking no other medication except her albuterol MDI.What other medication would you suggest be prescribed to her?

A)Levalbuterol MDI
B)Salmeterol MDI
C)Beclomethasone MDI
D)Oral tobramycin