Pulm TEST 100% VERIFIED SOLUTIONS

Pulm TEST 100% VERIFIED SOLUTIONS A 38-year-old woman presents with progressively worsening dyspnea and cough. She has never smoked cigarettes, has no known passive smoke exposure, and does not have any occupational exposure to chemicals. Pulmonary function testing shows obstructive lung disease that does not respond to bronchodilators. Which of the following is the most likely etiology? A. Radon exposure at home B. COPD C. a1-Antitrypsin deficiency D. Asthma - ANSWER C (This patient has a fixed airway obstruction consistent with COPD. The airway obstruction of asthma would be at least partially reversible on testing with a bronchodilator. cx1-Antitrypsin deficiency should be considered in a patient who develops COPD at a young age, especially if there is no other identifiable risk factor) A 60-year-old man is diagnosed with moderately severe (stage II) COPD. He admits to a long history of cigarette smoking and is still currently smoking. In counseling him about the benefits of smoking cessation, which of the following statements is most accurate? A. By quitting, his pulmonary function will significantly improve. B. By quitting, his current pulmonary function will be unchanged, but the rate of pulmonary function decline will slow. C. By quitting, his current pulmonary function and the rate of decline are unchanged, but there are cardiovascular benefits. D. By quitting, his pulmonary function will approach that of a nonsmoker of the same age - ANSWER B (Smoking cessation will not result in reversal of the lung damage that has already occurred, but can result in a slowing in the rate of decline of pulmonary function. In fact, smoking cessation can result in the rate of decline returning to that of a nonsmoker.) A 68-year-old patient of your practice with known COPD has pulmonary function testing showing an FEV 1 of 40% predicted has been having frequent exacerbations of his COPD. His Sa02 by pulse oximetry is 91%. Which of the following medication regimens is the most appropriate? A. Inhaled salmeterol BID and albuterol as needed B. Oral albuterol daily and inhaled fluticasone BID C. Inhaled fluticasone BID, inhaled tiotropium BID, and inhaled albuterol as needed D. Inhaled fluticasone BID, inhaled tiotropium BID, inhaled albuterol as needed, and home oxygen therapy - ANSWER C (This patient has stage III COPD with frequent exacerbations. He is best treated by a long-acting bronchodilator ( eg, tiotropium) and an inhaled steroid ( eg, fluticasone) used regularly, along with an inhaled, short-acting bronchodilator on an as-needed basis.)