[MCQ] Chronic Obstructive Pulmonary Disease- Part 3

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Chronic Obstructive Pulmonary Disease- Part 3

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Congratulations - you have completed Chronic Obstructive Pulmonary Disease- Part 3. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Adverse effect of Varenicline is ?

A	Dysphagia
B	Suicidal ideation
C	Hemoptysis
D	Seizure

Question 1 Explanation:

Therapy with an antidepressant bupropion or nicotine replacement therapy with varenicline are approved by USFDA as first-line treatments for nicotine dependence. Both drugs increase suicidal ideation and must be used with caution. Varenicline is more efficacious than bupropion or placebo

Question 2

Nicotine replacement therapy can be carried out by all routes except ?

A	Per rectal
B	Transdermal patches
C	Inhaler
D	Nasal spray

Question 2 Explanation:

Nicotine replacement therapy is available as gum, transdermal patches, inhaler & nasal spray

Question 3

Bronchodilator effect of anticholinergics is due to blocking the action of acetylcholine on ?

A	M1 muscarinic receptors
B	M2 muscarinic receptors
C	M3 muscarinic receptors
D	M4 muscarinic receptors

Question 3 Explanation:

Anticholinergics are effective bronchodilators because they block the action of acetylcholine on M3 muscarinic receptors that induce contraction on airway smooth muscle.

Question 4

Which of the following is a long-acting 2 adrenergic receptor agonist ?

A	Formoterol fumarate
B	Albuterol sulfate
C	Albuterol sulfate
D	None of the above

Question 5

Besides bronchodilator action, theophylline also has which of the following therapeutic effects ?

A	Anti-inflammatory effects
B	Inotropoic & diuretic effects
C	Augmenting skeletal muscle strength
D	All of the above

Question 5 Explanation:

Besides the bronchodilator effects of theophylline in COPD, it has anti-inflammatory, inotropoic and diuretic effects and has effects in augmenting skeletal muscle strength

Question 6

Only therapy demonstrated to decrease mortality in COPD patients is ?

A	Supplemental oxygen
B	Beta agonists
C	Theophylline
D	Glucocorticoids

Question 6 Explanation:

Supplemental O2 is the only pharmacologic therapy demonstrated to decrease mortality in COPD.

Question 7

Which of the following is an action of N-acetyl cysteine ?

A	Antioxidant
B	Anti-inflammtory
C	Anti-inflammtory
D	Mast cell stabilizer

Question 7 Explanation:

N-acetyl cysteine is used in COPD patients for its mucolytic and antioxidant properties.

Question 8

Eligibility for 1 antitrypsin augmentation therapy requires a serum 1 antitrypsin level of ?

A	< 6 µM
B	< 8 µM
C	< 10 µM
D	< 11 µM

Question 8 Explanation:

Eligibility for 1 antitrypsin augmentation therapy requires a serum 1 antitrypsin level < 11 (~ 50 mg/ dL) PiZ & null-null individuals and not in those with normal pulmonary function and a normal chest CT scan

Question 9

Which of the following vaccines is recommended before administering 1 antitrypsin augmentation therapy ?

A	Influenza vaccine
B	Polyvalent pneumococcal vaccine
C	Hepatitis B vaccination
D	All of the above

Question 9 Explanation:

Despite sterilization procedures for blood-derived products and the absence of reported cases of viral infection from  1 antitrypsin augmentation therapy, some physicians recommend hepatitis B vaccination prior to starting augmentation therapy.

Question 10

LVRS is used in the management of ?

A	Bronchial asthma
B	ILD
C	Chronic bronchitis
D	Emphysema

Question 10 Explanation:

Lung volume reduction surgery (LVRS) reduce volume of lung in emphysema.

Question 11

Lung volume reduction surgery (LVRS) is not recommended if pulmonary artery systolic pressure is ?

A	> 15 mmHg
B	> 25 mmHg
C	> 35 mmHg
D	> 45 mmHg

Question 11 Explanation:

LVRS is not recommended if patients of emphysema have significant pleural disease, a pulmonary artery systolic pressure >45 mmHg, extreme deconditioning, congestive heart failure, or other severe comorbid conditions.

Question 12

Patients with which of the following are not candidates for LVRS ?

A	FEV1 < 20% of predicted
B	Diffusely distributed emphysema on CT scan
C	DLCO < 20% of predicted
D	All of the above

Question 13

Patients with which of the following are most likely to benefit from LVRS ?

A	Upper lobe predominant emphysema
B	Middle lobe predominant emphysema
C	Lower lobe predominant emphysema
D	Any of the above

Question 13 Explanation:

Patients with upper lobe predominant emphysema and a low postrehabilitation exercise capacity are most likely to benefit from LVRS

Question 14

Bacteria frequently implicated in COPD exacerbations include all except ?

A	Streptococcus pneumoniae
B	Haemophilus influenzae
C	Staphylococcus aureus
D	Moraxella catarrhalis

Question 14 Explanation:

Bacteria frequently implicated in COPD exacerbations include S. pneumoniae, H. influenzae, Moraxella catarrhalis, M. pneumoniae or Chlamydia pneumoniae.

Question 15

Which of the following is not a parameter in ‘BODE score’ used as a predictor for COPD mortality ?

A	Breathing rate
B	Airflow obstruction
C	Dyspnoea
D	Exercise capacity

Question 16

Which of the following drugs is not included in the “not recommended or contraindicated” list in GOLD guidelines ?

A	Mucolytics
B	Narcotics
C	Antitussives
D	Vasodilators

Question 16 Explanation:

Use of mucolytic, antioxidant, immunoregulators, respiratory stimulants is not recommended in pharmacological treatments of COPD. Antitussives & vasodilators are contraindicated. Narcotics can relieve dyspnoea (potentially dangerous due to ventilatory suppression) & is used to manage symptoms in terminal situations.

Question 17

Which of the following is true as “Lung regeneration agent” ?

A	Retinoic acid (all-trans)
B	Retinoic acid receptor  agonists
C	Stem cells
D	All of the above

Question 17 Explanation:

Lung regeneration agents include Retinoic acid (all-trans), Retinoic acid receptor  agonists & Stem cells.

Question 18

Which of the following is used in the “Augmentation therapy” of COPD ?

A	Smoking cessation
B	Vaccines
C	Human plasma 1 antitrypsin
D	Supplemental oxygen

Question 18 Explanation:

In COPD, specific treatment of 1-AT deficiency consists of infusion of purified pooled human plasma 1 antitrypsin - known as augmentation therapy.

Question 19

Pooled human plasma is the source of which of the following preparations of purified 1 antitrypsin ?

A	Prolastin
B	Aralast
C	Zemaira
D	All of the above

Question 20

Which season is appropriate for giving influenza vaccination yearly in patients of COPD ?

A	Autumn
B	Winter
C	Spring
D	Spring

Question 20 Explanation:

Influenza vaccination reduces serious illness & death in COPD patients by 50%. Vaccination should be given once in autumn.

Question 21

Etiological factor in acute exacerbations of COPD includes ?

A	Viral infections
B	Bacterial infections
C	Particulate air pollutants
D	All of the above

Question 21 Explanation:

Main aetiological factors in acute exacerbations of COPD are viral & bacterial infections & air pollutants

Question 22

Risk factors predicting increased hospital admission for acute exacerbations in COPD include all except ?

A	Low body-mass index
B	High arterial carbon dioxide tension (PaCO2)
C	Degree of hypoxaemia
D	High mean pulmonary arterial pressure

Question 23

Risk factors predicting increased hospital admission for acute exacerbations in COPD include all except ?

A	Gas-exchange impairment
B	Severity of airflow obstruction
C	High arterial carbon dioxide tension (PaCO2)
D	High mean pulmonary arterial pressure

Question 23 Explanation:

Neither the severity of airflow obstruction nor the degree of hypoxaemia are predictive of hospital admission in COPD

Question 24

Which of the following is an effective respiratory stimulant ?

A	Doxapram
B	Cilomilast
C	Gefitinib
D	Batimastat

Question 24 Explanation:

Doxapram is an effective respiratory stimulant and can provide only minor short-term improvement in blood gas tensions in COPD.

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See all quizzes of Obstructive Pulmonary Disease at here:

Chronic Obstructive Pulmonary Disease- Part 1| Chronic Obstructive Pulmonary Disease- Part 2 | Chronic Obstructive Pulmonary Disease- Part 3

1.Adverse effect of Varenicline is ?
A. Dysphagia
B. Suicidal ideation
C. Hemoptysis
D. Seizure

2. Nicotine replacement therapy can be carried out by all routes except ?
A. Per rectal
B. Transdermal patches
C. Inhaler
D. Nasal spray

3. Bronchodilator effect of anticholinergics is due to blocking the action of acetylcholine on ?
A. M1 muscarinic receptors
B. M2 muscarinic receptors
C. M3 muscarinic receptors
D. M4 muscarinic receptors

4. Which of the following is a long-acting 2 adrenergic receptor agonist ?
A. Formoterol fumarate
B. Albuterol sulfate
C. Tiotropium bromide
D. None of the above

5. Besides bronchodilator action, theophylline also has which of the following therapeutic effects ?
A. Anti-inflammatory effects
B. Inotropoic & diuretic effects
C. Augmenting skeletal muscle strength
D. All of the above

6. Only therapy demonstrated to decrease mortality in COPD patients is ?
A. Supplemental oxygen
B. Beta agonists
C. Theophylline
D. Glucocorticoids

7. Which of the following is an action of N-acetyl cysteine ?
A. Antioxidant
B. Anti-inflammtory
C. Bronchodilator
D. Mast cell stabilizer

8. Eligibility for 1 antitrypsin augmentation therapy requires a serum  1 antitrypsin level of ?
A. < 6 
B. < 8 
C < 10 
D. < 11 

9. Which of the following vaccines is recommended before administering 1 antitrypsin augmentation therapy ?
A. Influenza vaccine
B. Polyvalent pneumococcal vaccine
C. Hepatitis B vaccination
D. All of the above

10. LVRS is used in the management of ?
A. Bronchial asthma
B. ILD
C. Chronic bronchitis
D. Emphysema

11. Lung volume reduction surgery (LVRS) is not recommended if pulmonary artery systolic pressure is ?
A. > 15 mmHg
B. > 25 mmHg
C. > 35 mmHg
D. > 45 mmHg

12. Patients with which of the following are not candidates for LVRS ?
A. FEV1 < 20% of predicted
B. Diffusely distributed emphysema on CT scan
C. DLCO < 20% of predicted
D. All of the above
13. Patients with which of the following are most likely to benefit from LVRS ?
A. Upper lobe predominant emphysema
B. Middle lobe predominant emphysema
C. Lower lobe predominant emphysema
D. Any of the above

14. Bacteria frequently implicated in COPD exacerbations include all except ?
A. Streptococcus pneumoniae
B. Haemophilus influenzae
C. Staphylococcus aureus
D. Moraxella catarrhalis

15. Which of the following is not a parameter in ‘BODE score’ used as a predictor for COPD mortality ?
A. Breathing rate
B. Airflow obstruction
C. Dyspnoea
D. Exercise capacity
16. Which of the following drugs is not included in the “not recommended or contraindicated” list in GOLD guidelines ?
A. Mucolytics
B. Narcotics
C. Antitussives
D. Vasodilators

17. Which of the following is true as “Lung regeneration agent” ?
A. Retinoic acid (all-trans)
B. Retinoic acid receptor  agonists
C. Stem cells
D. All of the above

18. Which of the following is used in the “Augmentation therapy” of COPD ?
A. Smoking cessation
B. Vaccines
C. Human plasma 1 antitrypsin
D. Supplemental oxygen

19. Pooled human plasma is the source of which of the following preparations of purified 1 antitrypsin ?
A. Prolastin
B. Aralast
C. Zemaira
D. All of the above
20. Which season is appropriate for giving influenza vaccination yearly in patients of COPD ?
A. Autumn
B. Winter
C. Spring
D. Summer

21. Etiological factor in acute exacerbations of COPD includes ?
A. Viral infections
B. Bacterial infections
C. Particulate air pollutants
D. All of the above

22. Risk factors predicting increased hospital admission for acute nexacerbations in COPD include all except ?
A. Low body-mass index
B. High arterial carbon dioxide tension (PaCO2)
C. Degree of hypoxaemia
D. High mean pulmonary arterial pressure
23. Risk factors predicting increased hospital admission for acute exacerbations in COPD include all except ?
A. Gas-exchange impairment

B. Severity of airflow obstruction
C. High arterial carbon dioxide tension (PaCO2)
D. High mean pulmonary arterial pressure

24. Which of the following is an effective respiratory stimulant ?
A. Doxapram
B. Cilomilast
C. Gefitinib
D. Batimastat

Chronic Obstructive Pulmonary Disease

[MCQ] Chronic Obstructive Pulmonary Disease- Part 3

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Chronic Obstructive Pulmonary Disease- Part 3

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