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

Question 1

A genetically linked cause of panlobular emphysema is:

A) bronchiectasis.
B) alpha₁-antitrypsin deficiency.
C) cystic fibrosis.
D) bronchial asthma.

Answer 1

alpha₁-antitrypsin deficiency.

Question 2

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

A) 35 years
B) 40 years
C) 45 years
D) 50 years

Answer 2

40 years

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

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

Answer 3

2, 3, 4

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

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

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

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

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

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

Question 7

Nonpharmacologic treatment of COPD includes which of the following?

A) Limiting physical activity
B) Avoidance of pneumococcal vaccine as it can trigger exacerbations
C) Interventional bronchoscopy and surgery
D) Administration of long-acting antimuscarinic antagonist

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%

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

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.

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

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.

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

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

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

Question 12

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

A) Normal in all cases
B) Decreased in emphysema
C) Decreased in chronic bronchitis
D) Increased in all cases

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

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

Question 14

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

A) Truman's sign
B) Burton's sign
C) Carr's sign
D) Hoover's sign

Question 15

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

A) Z
B) MZ
C) MM
D) ZZ

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

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

Question 17

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

A) Exposure to fungal spores in the soil
B) Genetic predisposition
C) Exposure to influenza viruses
D) Cigarette smoking

Question 18

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

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