NR601 MIDTERM QUESTIONS AND ANSWERS

NR601 MIDTERM QUESTIONS AND
ANSWERS



Whatxarexthex3xprimaryxphysiologicalxchangesxofxaging?x-
x1.xReducedxphysiologicalxreservexofxmostxbodyxsystems,xesp.xcardiac,xresp,xrenal.



2.xReducedxhomeostaticxmechanismsxthatxfailxtoxadjustxregulatoryxsystemsx(i.e.xtempxcon
trol,xfluid/lytexbalance,xetc.).

3.xImpairedximmunologicalxfunctionx(infectionxriskxisxgreater,xautoimmunexdz'sxmorexprev
alent)

Whatxisxthexpreferredxamountxofxexercisexforxelderly?x-x30min/dayx5xdays/
wkxofxmoderatexexercise.

Ifxtryingxtoxlosexwt:x60min/day.

WhatxarexPFTs?x-
xGroupxofxtestsxthatxprovidexquantifiablexmeasurementxofxlungxfunction,xusedxtoxdxxrespxa

bnormalitiesxorxassessxprogression/resolutionxofxlungxdz.

WhatxisxFEV1?x-xForcedxExpiratoryxVolumexinx1xsecondx(80-120%)

WhatxisxFVC?x-xForcedxVitalxCapacityx(80-120%)

WhatxisxnormalxFEV1/FVCxratio?x-x<0.7x(70%)

WhatxisxGOLDx1xcriteria?x-xMild
FEV1x>/=x80%xpredicted

WhatxisxGOLDx2xcriteria?x-xModerate
FEV1x50-79%xpredicted

WhatxisxGOLDx3xcriteria?x-xSevere
FEV1x30-49%xpredicted

WhatxisxGOLDx4xcriteria?x-xVeryxsevere
FEV1x<30%xpredicted

,WhatxarexthexsignalxsymptomsxofxCOPD?x-xDyspnea
Chronicxcoughxw/sputum
Decreasedxactivityxtolerance
Wheezing

WhatxarexcharacteristicsxofxCOPD?x-xCommon,xpreventable,xtreatable.

Characterizedxbyxpersistentxairflowxlimitation.

Usuallyxprogressive,xassociatedxwithxenhancedxchronicxinflammatoryxresponsexinxairway
sxandxlungsxtoxnoxiousxparticles/gases

Airwayxfibrosis,xluminalxplugs,xairwayxinflammation,xincreasedxairwayxresistance,xsmallxai
rwayxdz.

Decreasedxelasticxrecoilxofxalveoli.

WhatxarexriskxfactorsxforxCOPD?x-xSmokingx(increasingxw/numberxofxpackxyears)
Secondxhandxsmoke
Environmentalxpollutionx(endotoxins,xcoalxdust,xmineralxdust)

WhatxisxseenxonxphysxexamxinxCOPD?x-xMayxbexnormalxinxearlyxstates

Asxseverityxprogresses:xlungxhyperinflation,xdecreasedxbreathxsounds,xwheezesxatxbases
,xdistantxheartxtonesx(b/cxofxhyperinflation,xsoxS1/
S2xsoundsxoffxinxdistance),xaccessoryxmusclexuse,xpursedxlipxbreathing,xincreasedxexpira
toryxphase,xneckxveinxdistention.

HowxisxCOPDxdiagnosed?x-xSpirometryxisxgoldxstandardx(prexandxpostxbronchodilator).
Irreversiblexairflowxlimitationxisxhallmark.

HowxisxCOPDxtreated?x-xBronchodilators:xbetaxagonistsx(long/
short),xanticholinergicsx(long/short),xorxcombo.

WhatxisxthexMOAxofxbetaxagonists?x-xStimulatesxbeta-2-
adrenergicxreceptors,xincreasingxcyclicxAMP,xresultingxinxrelaxingxairways.

WhatxisxthexMOAxofxanticholinergics?x-
xBlockxthexeffectxofxacetylcholinexonxmuscarinicxtypex3xreceptors,xresultingxinxbronchodilat

ion.

Whyxarexlong-actingxbetaxagonistsxprescribedxforxCOPD?x-
xTheyxarexforxmoderatexairflowxlimitation.

, Theyxrelievexsymptoms,xincreasexexercisextolerance,xreducexnumberxofxexacerbations,xi
mprovexQOL.

WhatxarexsomexnonxpulmonaryxdiagnosesxthatxresultxinxCOPD-typexsymptoms?x-xCHF
Hyperventilationxsyndrome
Panicxattacks
Vocalxcordxdysfunction
Obstructivexsleepxapnea
Aspergillosis
Chronicxfatiguexsyndrome

Whatxarexsignalxsymptomsxofxasthma?x-xWheezing
Shortnessxofxbreath
Coughx(espxatxnight)
Chestxtightness

Whatxisxchronicxbronchitis?x-xDailyxchronicxcoughxw/
increasedxsputumxforxatxleastx3xconsecutivexmonthsxinxatxleastx2xconsecutivexyears.

Usuallyxworsexonxwakening.

MayxorxmayxnotxbexassociatedxwithxCOPD.

Whatxisxemphysema?x-
xCharacterizedxbyxobstructionxtoxairflowxcausedxbyxabnormalxairspacexenlargement xdistal

xtoxterminalxbronchioles.



Chronicxinflammation/remodeling,xtrappingxair,xhinderingxeffectivexO2/
CO2xexchangex(allxduextoxinflammatoryxmediatorsxinfiltratingxairways).

Whatxarexsignalxsymptomsxofxischemicxheartxdz?x-xChestxpain
Chestxtightness
Chestxdiscomfort

Whatxisxischemicxheartxdz?x-
xImbalancexbetweenxsupplyxandxdemandxforxbloodxflowxtoxmyocardium



WhatxarexsignalxsymptomsxofxlungxCA?x-xCough
Dyspnea
Wtxloss
Anorexia
Hemoptysis

WhatxisxlungxCA?x-xMalignantxneoplasmxoriginatingxinxparenchymaxofxlung/airways

WhatxarexsignalxsymptomsxofxMI?x-xProlongedxCPx(>20minxduration)