Question 1

A genetically linked cause of panlobular emphysema is:

Accepted Answer

Alpha-1 antitrypsin deficiency is a genetic condition that can lead to panlobular emphysema by reducing the amount of alpha-1 antitrypsin protein, which protects the lungs from neutrophil elastase.

Question 2

According to GOLD, at what age can the initial diagnosis of COPD be made?

Accepted Answer

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, the initial diagnosis of COPD can be considered in individuals who are over 40 years of age and have respiratory symptoms and a history of exposure to risk factors.

Question 3

Emphysema may be caused by which of the following? 1) Inhaling asbestos fibers 2) alpha₁-antitrypsin deficiency 3) Secondhand cigarette smoke 4) Air pollution

Accepted Answer

Emphysema, a type of chronic obstructive pulmonary disease (COPD), can be caused by alpha-1 antitrypsin deficiency (a genetic condition), secondhand cigarette smoke, and air pollution. Inhaling asbestos fibers is more closely associated with asbestosis and mesothelioma rather than emphysema.

Question 4

Which of the following are clinical findings associated with chronic bronchitis? 1) Fever 2) Purulent sputum 3) Right heart failure 4) Elevated CO₂ level

Accepted Answer

Chronic bronchitis, a form of chronic obstructive pulmonary disease (COPD), is characterized by the presence of a productive cough with purulent sputum for at least three months in two consecutive years. Over time, chronic bronchitis can lead to complications such as right heart failure (cor pulmonale) due to the increased pressure in the pulmonary arteries. The mention of "Elevated CO₂ level" is not relevant to known clinical markers or findings in chronic bronchitis, suggesting a typographical or encoding error. Fever is not a typical finding in chronic bronchitis unless there is an acute exacerbation or infection.

Question 5

Which of the following clinical manifestations are associated with late-stage chronic bronchitis?
1) Rhonchi
2) Cor pulmonale
3) Digital clubbing
4) Severe weight loss and thin build

Accepted Answer

Late-stage chronic bronchitis can lead to cor pulmonale due to long-standing pulmonary hypertension, digital clubbing from chronic hypoxia, and rhonchi due to mucus in the airways. Severe weight loss and thin build are more characteristic of emphysema, another type of chronic obstructive pulmonary disease (COPD), rather than chronic bronchitis.

Question 6

Which of the following term(s) is/are commonly applied to a patient with emphysema?
1) Pink puffer
2) Blue bloater
3) Type A COPD
4) Type B COPD

Accepted Answer

Patients with emphysema are often referred to as "pink puffers" and are classified as Type A COPD.

Question 7

Nonpharmacologic treatment of COPD includes which of the following?

Accepted Answer

Interventional bronchoscopy and surgery are nonpharmacologic treatments for COPD that can help manage symptoms and improve quality of life in selected patients.

Question 8

Which of the following are used to confirm the diagnosis of COPD? 1) Presence of a chronic cough 2) Chronic exposure to environmental smoke 3) FEV₁/FVC ratio greater than 0.70 4) FEV₁< 80%

Accepted Answer

The answer of Which of the following are used to...

Question 9

The primary goals of COPD assessment should:
1) include the establishment of the degree of air flow limitation.
2) include the assessment of family members likely to be affected.
3) determine the impact of the COPD on the patient's health status.
4) include retrospective chart examination to determine any missed exacerbations.

Accepted Answer

The primary goals of COPD (Chronic Obstructive Pulmonary Disease) assessment include establishing the degree of airflow limitation and determining the impact of COPD on the patient's health status. Assessing family members or retrospective chart examination for missed exacerbations are not primary goals of COPD assessment.

Question 10

Which of the following statements accurately describes the anatomic alterations of the lungs associated with emphysema?
1) It is the weakening and permanent enlargement of the air spaces distal to the terminal bronchioles.
2) It is most closely associated with cystic fibrosis.
3) The distal airways tend to collapse during expiration in response to increased intrapleural pressure.
4) It is characterized by thick secretions and mucus plugging.

Accepted Answer

Emphysema involves the weakening and permanent enlargement of air spaces distal to the terminal bronchioles and is characterized by the collapse of distal airways during expiration due to increased intrapleural pressure.

Question 11

Which of the following are anatomic alterations found with chronic bronchitis?
1) Increased size of submucosal bronchial glands
2) Destruction of pulmonary capillaries
3) Chronic bronchial wall inflammation and thickening
4) Bronchospasm

Accepted Answer

Chronic bronchitis is characterized by increased size of submucosal bronchial glands, chronic bronchial wall inflammation and thickening, and bronchospasm. Destruction of pulmonary capillaries is more characteristic of emphysema, another type of chronic obstructive pulmonary disease (COPD).

Question 12

Which of the following is true of the diffusing capacity test (DL_CO) findings in a patient with COPD?

Accepted Answer

In COPD, the diffusing capacity (DLCO) is typically decreased in emphysema due to the destruction of alveolar walls and loss of capillary beds, which reduces the surface area available for gas exchange.

Question 13

Which of the following clinical manifestations would be expected in a patient with emphysema?
1) Polycythemia
2) Barrel chest
3) Pursed-lip breathing
4) Normal percussion note

Accepted Answer

Patients with emphysema often exhibit a barrel chest due to hyperinflation of the lungs and use pursed-lip breathing to help keep airways open during exhalation.

Question 14

What is the term for the inward movement of the lateral chest wall during inspiration?

Accepted Answer

Hoover's sign refers to the inward movement of the lateral chest wall during inspiration, typically seen in cases of severe chronic obstructive pulmonary disease (COPD). It indicates a flattening of the diaphragm due to hyperinflation of the lungs.

Question 15

The genetic reference to a person with a normal level of alpha₁-antitrypsin is _____ phenotype.

Accepted Answer

The normal phenotype for alpha-1 antitrypsin is MM, indicating the presence of two normal M alleles.

Question 16

Which of the following are pathologic alterations found with emphysema?
1) Air trapping and hyperinflation
2) Mucus plugs
3) Decreased surface area for gas exchange
4) Weakened respiratory bronchioles

Accepted Answer

Emphysema is characterized by air trapping and hyperinflation due to the destruction of alveolar walls, leading to decreased surface area for gas exchange. The weakening of respiratory bronchioles also contributes to the disease's pathology. Mucus plugs are more characteristic of chronic bronchitis, another type of chronic obstructive pulmonary disease (COPD), rather than emphysema specifically.

Question 17

According to the GOLD report, which of the following is the greatest worldwide risk factor for COPD?

Accepted Answer

Cigarette smoking is identified as the greatest worldwide risk factor for Chronic Obstructive Pulmonary Disease (COPD) according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) report.

Question 18

The management of COPD may include:
1) bi-annual influenza immunization.
2) bronchopulmonary hygiene procedures.
3) bronchodilators.
4) smoking cessation.

Accepted Answer

Bronchopulmonary hygiene procedures, bronchodilators, and smoking cessation are all part of managing COPD. Influenza immunization is recommended annually, not bi-annually.

Quiz 13: Chronic Obstructive Pulmonary Disease, Chronic Bronchitis and Emphysema

A genetically linked cause of panlobular emphysema is:

According to GOLD, at what age can the initial diagnosis of COPD be made?

Emphysema may be caused by which of the following? 1) Inhaling asbestos fibers 2) alpha1-antitrypsin deficiency 3) Secondhand cigarette smoke 4) Air pollution

Which of the following are clinical findings associated with chronic bronchitis? 1) Fever 2) Purulent sputum 3) Right heart failure 4) Elevated CO2 level

Which of the following clinical manifestations are associated with late-stage chronic bronchitis? 1) Rhonchi 2) Cor pulmonale 3) Digital clubbing 4) Severe weight loss and thin build

Which of the following term(s) is/are commonly applied to a patient with emphysema? 1) Pink puffer 2) Blue bloater 3) Type A COPD 4) Type B COPD

Nonpharmacologic treatment of COPD includes which of the following?

Which of the following are used to confirm the diagnosis of COPD? 1) Presence of a chronic cough 2) Chronic exposure to environmental smoke 3) FEV1/FVC ratio greater than 0.70 4) FEV1 < 80%

Which of the following are anatomic alterations found with chronic bronchitis? 1) Increased size of submucosal bronchial glands 2) Destruction of pulmonary capillaries 3) Chronic bronchial wall inflammation and thickening 4) Bronchospasm

Which of the following is true of the diffusing capacity test (DLCO) findings in a patient with COPD?

Which of the following clinical manifestations would be expected in a patient with emphysema? 1) Polycythemia 2) Barrel chest 3) Pursed-lip breathing 4) Normal percussion note