What layers make up the mucosal blanket that covers the airways?
- Gel and Sol
- Mucus glands and globet cells
- Alveolar type I and II cells
- Clara cells and cilia
Corticosteroids are described as which of the following?
- Smooth muscle dilators
- Antiinflammatory agents
- Lipid soluble agents
Cromolyn sodium is indicated in all but which of the following conditions?
- Acute asthma
- Asthma prophylaxis
- Exercise induced asthma
- Allergic rhinitis
Patients with mild asthma are often treated with Xolair injections.
Antileukotriene drugs are beneficial in the treatment of aspirin-induced asthma.
All BUT WHICH of the following are complications that may occur with the use of exogenous surfactant?
Which of the following disease are characterized by hypersecretion of mucus?
- Congestive heart failure
- Chronic bronchitis
- Cystic fibrosis
Which of the following would occur if it is determined that an alveolus has a surface tension of 40 dynes and a radius of 4 centimeters?
- 20 cmH2O would be required to inflate alveolus; patient’s WOB woudl decrease
- 40 cmH2O would be required to inflate alveolus; patient’s WOB would decrease
- 20 cmH2O would be required to inflate alveolus; pateint’s WOB would increase
- 40 cmH2O would be required to inflate alveolus; patient’s WOB would increase
A patient receiving both Azmacort and Proventil questions the practitioner about why both drugs are needed. The best answer is:
- “Azmacort treats wheezing and Proventil prevents future asthma attacks
- Proventil works quickly to relax your airways and Azmacort helps reduce the inflammation
- The doctor ordered both to be taken once every night
- Azmacort usually causes bronchospasm, so we are giving you Proventil to treat this side effect
The same patient using combination Steroid and Bronchodilator is discharged from a hospital. The patient is sent home with orders for both Azmacort and Proventil MDIs. What is most critical that the patient understand?
- That use of the MDIs may elicit a cough
- That Proventil is also available in a nebulization solution
- That Azmacort is a controller and not to be used during an acute attack
- That Azmacort should be discontinued after wheezing stops
If a patient experiences an asthma attack as a result of exposure to cats, the asthma would be categorized as which of the following?
Side effects of aerosolized Mucomyst may include:
- Bronchospasm, acute airway obstruction, and nausea
- Bronchodilation, oropharyngeal irritation, and acute airway obstruction
- Fluid overload, bronchospasm, and oropharyngeal irritation
- Liver damage, bronchospasm, and corrosion of metal dental work
Which of the following should be stressed when instructing a new patient in the use of aerosolized steroids?
- Use the MDI steroids only when symptoms are severe
- Taper steroid use gradually under a physician’s supervision
- Adjust dosage and frequency according to how it “feels”
- Alternate MDI steroids with other antiasthmatic drugs
What is the mode of action of Acetylcysteine in promoting mucolysis?
- Disruption of plasma proteins
- Increase of mucus alkalinity
- Hygroscopic properties
- Disruption of disulfide bonds
Allergic and nonallergic rhinitis would be treated with which of the following forms of corticosteroids?
- Nasal spray
Which of the following would be recommended to properly administer Survanta to a 1200 gram infant?
- Administer 4 doses of Survanta 1.2 ml via the ET tube
- Rotate infant twice during administration of the drug
- Administer 2 doses of Survanta 3 ml via the ET tube
- Rotate infant four times during administration of the drug
- Provide positive pressure ventilation for 30 to 4545 seconds after each
- Suction infant immediately after administration to clear airway
When administering corticosteroids by the aerosol route, local side effects to monitor include:
- Appearance of nasal polyps
- Appearance of thrush
- HPA suppression
All but which of the following are possible side effects seen with systemic administration of corticosteroids?
- HPA suppression
- Slow growth in children
Cromolyn sodium accomplishes which of the following?
- Stabilizes leukotrienes
- Stabilizes mast cells
- Prevents histamine release
- Prevents eosinophil degranulation
Which of the following does not appropriately describe Cromolyn sodium?
- Mast cell stabilizer
- Controller drug
Which of the following reactions may occur when using aerosolized corticosteroids for a local effect?
- Oral fungal infections
- Pulmonary aspergillosis
- Delayed healing
- Adult-onset diabetes
Corticosteroids are naturally secreted by which of the following?
- Thymal cortex – outer zone
- Adrenal cortex – outer zone
- Adrenal cortex – inner zone
- Thymal cortex – inner zone
Glucocorticoids inhibit all but which of the following cells of inflammation?
- Red blood cells
- Mast cells
Which of the following minimizes local side effects associated with use of inhaled corticosteroids?
- Use a spacer device
- Rinse mouth after each treatment
- Prescribe the lowest effective dose
Which surfactant preparation is derived from the lung of a calf?
- Dornase Alfa
Aerosol therapy via ultrasonic nebulization has been ordered for the purpose of sputum induction. The patient has thick, copious secretions with frequent mucous plugging. Given that the patient is also asthmatic, what modification of the order should the CRT recommend?
- Discontinue the ultrasonic order
- Add Mucomyst to the ultrasonic nebulizer
- Add a bronchodilator to the ultrasonic nebulizer
- Use a small-volume nebulizer with a bronchodilator and Mucomyst
A pediatric pulmonologist prescribes Singulair to a 10-year-old female with asthma. What recommendations would you give to this child and her parents?
- Take a 4 mg tablet every morning
- Take a 10 mg tablet daily
- Take a 5 mg tablet daily
- Take a 4 mg packet of granules every evening
Mucomyst should not be aerosolized with which of the following due to incompatibility?
- Amphotericin B
Which of the following statements concerning Mucomyst is NOT correct?
- It is a mucolytic
- It can be used to treat Advil overdose
- It can be administered directly into an endotracheal tube
- It has a bad odor.
Which of the following should not be recommended for treating severe asthma?
- Cromolyn Sodium
The equation describing the relationship between the internal pressure of a bubble, its surface tension, and the radius is:
- Fick’s Law
- Starling’s Law
- Venturi’s principle
- Laplace’s Law
An asthmatic patient is about to be discharged from the hospital. What information must the CRT give the patient before the patient leaves the hospital?
- How to avoid asthma triggers
- How to use metered-dose inhalers (MDI)
- How to determine which peak flow meter test is best
- How to taper oral corticosteroids
Which of the following are indications for exogenous surfactant therapy
- Prevention of sudden infant death syndrome in premature infants
- Prevention of RDS in low birth weight infants
- Rescue treatment for bronchodpulmonary hyperplasia
- Rescue treatment for RDS
Acetylcysteine may be delivered by which of the following routes?
- Topical (direct instillation)
- All of the above
All but which of the following slow the rate of mucociliary transport?
- Cigarette smoking
- Beta agonists
Which of the following occur during an asthma attack?
- Release of epinephrine
- Mucosal edema
- Increased secretions
Which of the following are methods of producing natuaral surfactants?
- Use of aminotic fluid
- Alveolar wash
Which of the following drugs breaks down the DNA of infected secretions in patients with cystic fibrosis?
- Pancreatic dornase
- Dornalse alfa
When administring Survanta as a prevention therapy to RDS, a premature infant less than 1250 grams should be given the drug _____________________.
- 15 minutes after birth
- 1 hour after birth
- 6 hours after birth
- 48 hours after birth