NSG 555 COMPREHENSIVE EXAM UPDATED QUESTIONS
AND SOLUTIONS GRADED A+
✔✔What is the main difference between dry and wet age-related macular
degeneration? - ✔✔Dry is gradual and progressive due to atrophy, while wet involves
rapid vision loss due to choroidal new vessel growth.
✔✔What are common risk factors for age-related macular degeneration? - ✔✔Aging,
smoking, genetics/family history, and low antioxidant diet.
✔✔What treatments are available for dry age-related macular degeneration? -
✔✔Pegcetacoplan and avacincaptad pegol.
✔✔What treatments are available for wet age-related macular degeneration? -
✔✔Inhibitors of vascular endothelial growth factors such as ranibizumab, bevacizumab,
aflibercept, faricimab, and prolucizumab.
✔✔What is the leading cause of irreversible central vision loss in developing countries?
- ✔✔Age-related macular degeneration.
✔✔What is the primary difference between cataracts and macular degeneration? -
✔✔Cataracts affect the lens and vision loss is reversible with surgery; macular
degeneration affects central vision and is not reversible.
✔✔What are the differences in onset between asthma and COPD? - ✔✔Asthma
typically begins in childhood/adolescence, while COPD usually occurs in adults over 40.
✔✔How do symptoms differ between asthma and COPD? - ✔✔Asthma symptoms are
episodic, whereas COPD symptoms are constant and progressive.
✔✔What is the first line treatment for asthma compared to COPD? - ✔✔Asthma is
treated with inhaled corticosteroids (ICS), while COPD is managed with bronchodilators.
✔✔What associated conditions are linked to asthma and COPD? - ✔✔Asthma is
associated with eczema and allergies; COPD is associated with smoking.
✔✔How is asthma diagnosed? - ✔✔Through a history of variable symptoms (wheeze,
shortness of breath, chest tightness, cough) and spirometry showing significant
improvement after bronchodilator use.
✔✔How does the post-bronchodilation response in asthma differ from COPD? - ✔✔In
asthma, the post-bronchodilation response is usually marked, while COPD shows little
change.
,✔✔What is the recommended medication for asthma symptoms less than 4-5 days a
week? - ✔✔Low-dose ICS-formoterol as-needed.
✔✔What treatment is suggested for asthma symptoms occurring most days or waking
with asthma once a week? - ✔✔Low-dose maintenance ICS-formoterol and low-dose
ICS-formoterol reliever.
✔✔What is the treatment for asthma with daily symptoms or low lung function? -
✔✔Medium-dose maintenance ICS-formoterol and low-dose ICS-formoterol reliever.
✔✔What additional treatment is recommended for severe asthma cases? - ✔✔Add-on
LAMA and consider referral for phenotype assessment; may include high-dose ICS-
formoterol and biologics like anti-IgE, anti-IL5/5R, anti-ILRx, or anti-TSLP.
✔✔When should oral corticosteroids be considered for asthma patients? - ✔✔In Steps 4
and 5, for patients presenting with severely uncontrolled asthma.
✔✔What are the indications for prescribing oral corticosteroids in asthma management?
- ✔✔Worsening symptoms not responding to increased reliever or ICS for 2-3 days,
rapid deterioration, or FEV1/PEF <60% normal.
✔✔What is the recommended dosage for adults taking oral corticosteroids for asthma?
- ✔✔40-50mg in the morning for 5-7 days.
✔✔What does the GINA guideline state about antibiotics for asthma exacerbations? -
✔✔Do not routinely prescribe antibiotics for exacerbations.
✔✔What is the typical duration of a chronic cough? - ✔✔A chronic cough lasts over 8
weeks.
✔✔What are the clinical findings associated with chronic cough? - ✔✔Usually resolves
within 3 weeks; persistent, usually dry, minimally productive cough.
✔✔What should be considered if a cough lasts more than 3 weeks? - ✔✔Consider
pertussis.
✔✔What diagnostic test is recommended if a cough persists for more than 8 weeks? -
✔✔CXR (chest X-ray) if ACE inhibitor therapy is current and post-infectious cough is
ruled out.
✔✔What should be done if pertussis is suspected in a chronic cough case? -
✔✔Perform PCR testing.
, ✔✔What are the treatment options for a positive pertussis diagnosis? - ✔✔Treat with a
macrolide and revaccinate with Tdap.
✔✔What treatment is suggested for upper airway cough syndrome (UACS)? - ✔✔Give
decongestants or first-generation antihistamines.
✔✔What are the treatment options for refractory chronic cough? - ✔✔Lidocaine,
morphine sulfate, or speech therapy with pregabalin or gabapentin.
✔✔How is Chronic Obstructive Pulmonary Disease (COPD) diagnosed? - ✔✔Presence
of chronic respiratory symptoms and confirmed by non-fully reversible airflow
obstruction (FEV1/FVC <0.7 post-bronchodilation).
✔✔What are the GOLD grades for COPD based on FEV1? - ✔✔1: ≥80% predicted, 2:
50-79%, 3: 30-49%, 4: <30%.
✔✔What defines the severity and exacerbation risk in COPD? - ✔✔E: ≥2 moderate
exacerbations or 1 requiring hospitalization; A: 0-1 moderate exacerbation (not
hospitalized) with mMRC 0-1 and CAT <10; B: 0-1 moderate exacerbation (not
hospitalized) with mMRC ≥2 and CAT ≥10.
✔✔What medication is indicated for chronic bronchitis in severe COPD with a history of
exacerbations? - ✔✔PDE Inhibitor (roflumilast).
✔✔What vaccinations are recommended for COPD patients? - ✔✔COVID-19, flu,
pneumococcal, RSV, Tdap, shingles.
✔✔What inhaler combination is not recommended for asthma management? - ✔✔LABA
+ ICS; instead, use triple therapy LABA + LAMA + ICS.
✔✔What is the recommended treatment for Group E in COPD management? -
✔✔LABA + LAMA; consider adding ICS if blood eosinophils are 300 or greater.
✔✔What is the first-line treatment for exacerbations in COPD? - ✔✔SABA with or
without SAMA.
✔✔When should antibiotics be used in COPD exacerbations? - ✔✔When signs of
bacterial infection are present; azithromycin for 5 days.
✔✔What is the maximum duration for systemic corticosteroids during COPD
exacerbations? - ✔✔No more than 5 days.
✔✔What is the essential criterion for diagnosing Pulmonary Arterial Hypertension
(PAH)? - ✔✔Mean Pulmonary Artery pressure of 25 mmHg or higher.
AND SOLUTIONS GRADED A+
✔✔What is the main difference between dry and wet age-related macular
degeneration? - ✔✔Dry is gradual and progressive due to atrophy, while wet involves
rapid vision loss due to choroidal new vessel growth.
✔✔What are common risk factors for age-related macular degeneration? - ✔✔Aging,
smoking, genetics/family history, and low antioxidant diet.
✔✔What treatments are available for dry age-related macular degeneration? -
✔✔Pegcetacoplan and avacincaptad pegol.
✔✔What treatments are available for wet age-related macular degeneration? -
✔✔Inhibitors of vascular endothelial growth factors such as ranibizumab, bevacizumab,
aflibercept, faricimab, and prolucizumab.
✔✔What is the leading cause of irreversible central vision loss in developing countries?
- ✔✔Age-related macular degeneration.
✔✔What is the primary difference between cataracts and macular degeneration? -
✔✔Cataracts affect the lens and vision loss is reversible with surgery; macular
degeneration affects central vision and is not reversible.
✔✔What are the differences in onset between asthma and COPD? - ✔✔Asthma
typically begins in childhood/adolescence, while COPD usually occurs in adults over 40.
✔✔How do symptoms differ between asthma and COPD? - ✔✔Asthma symptoms are
episodic, whereas COPD symptoms are constant and progressive.
✔✔What is the first line treatment for asthma compared to COPD? - ✔✔Asthma is
treated with inhaled corticosteroids (ICS), while COPD is managed with bronchodilators.
✔✔What associated conditions are linked to asthma and COPD? - ✔✔Asthma is
associated with eczema and allergies; COPD is associated with smoking.
✔✔How is asthma diagnosed? - ✔✔Through a history of variable symptoms (wheeze,
shortness of breath, chest tightness, cough) and spirometry showing significant
improvement after bronchodilator use.
✔✔How does the post-bronchodilation response in asthma differ from COPD? - ✔✔In
asthma, the post-bronchodilation response is usually marked, while COPD shows little
change.
,✔✔What is the recommended medication for asthma symptoms less than 4-5 days a
week? - ✔✔Low-dose ICS-formoterol as-needed.
✔✔What treatment is suggested for asthma symptoms occurring most days or waking
with asthma once a week? - ✔✔Low-dose maintenance ICS-formoterol and low-dose
ICS-formoterol reliever.
✔✔What is the treatment for asthma with daily symptoms or low lung function? -
✔✔Medium-dose maintenance ICS-formoterol and low-dose ICS-formoterol reliever.
✔✔What additional treatment is recommended for severe asthma cases? - ✔✔Add-on
LAMA and consider referral for phenotype assessment; may include high-dose ICS-
formoterol and biologics like anti-IgE, anti-IL5/5R, anti-ILRx, or anti-TSLP.
✔✔When should oral corticosteroids be considered for asthma patients? - ✔✔In Steps 4
and 5, for patients presenting with severely uncontrolled asthma.
✔✔What are the indications for prescribing oral corticosteroids in asthma management?
- ✔✔Worsening symptoms not responding to increased reliever or ICS for 2-3 days,
rapid deterioration, or FEV1/PEF <60% normal.
✔✔What is the recommended dosage for adults taking oral corticosteroids for asthma?
- ✔✔40-50mg in the morning for 5-7 days.
✔✔What does the GINA guideline state about antibiotics for asthma exacerbations? -
✔✔Do not routinely prescribe antibiotics for exacerbations.
✔✔What is the typical duration of a chronic cough? - ✔✔A chronic cough lasts over 8
weeks.
✔✔What are the clinical findings associated with chronic cough? - ✔✔Usually resolves
within 3 weeks; persistent, usually dry, minimally productive cough.
✔✔What should be considered if a cough lasts more than 3 weeks? - ✔✔Consider
pertussis.
✔✔What diagnostic test is recommended if a cough persists for more than 8 weeks? -
✔✔CXR (chest X-ray) if ACE inhibitor therapy is current and post-infectious cough is
ruled out.
✔✔What should be done if pertussis is suspected in a chronic cough case? -
✔✔Perform PCR testing.
, ✔✔What are the treatment options for a positive pertussis diagnosis? - ✔✔Treat with a
macrolide and revaccinate with Tdap.
✔✔What treatment is suggested for upper airway cough syndrome (UACS)? - ✔✔Give
decongestants or first-generation antihistamines.
✔✔What are the treatment options for refractory chronic cough? - ✔✔Lidocaine,
morphine sulfate, or speech therapy with pregabalin or gabapentin.
✔✔How is Chronic Obstructive Pulmonary Disease (COPD) diagnosed? - ✔✔Presence
of chronic respiratory symptoms and confirmed by non-fully reversible airflow
obstruction (FEV1/FVC <0.7 post-bronchodilation).
✔✔What are the GOLD grades for COPD based on FEV1? - ✔✔1: ≥80% predicted, 2:
50-79%, 3: 30-49%, 4: <30%.
✔✔What defines the severity and exacerbation risk in COPD? - ✔✔E: ≥2 moderate
exacerbations or 1 requiring hospitalization; A: 0-1 moderate exacerbation (not
hospitalized) with mMRC 0-1 and CAT <10; B: 0-1 moderate exacerbation (not
hospitalized) with mMRC ≥2 and CAT ≥10.
✔✔What medication is indicated for chronic bronchitis in severe COPD with a history of
exacerbations? - ✔✔PDE Inhibitor (roflumilast).
✔✔What vaccinations are recommended for COPD patients? - ✔✔COVID-19, flu,
pneumococcal, RSV, Tdap, shingles.
✔✔What inhaler combination is not recommended for asthma management? - ✔✔LABA
+ ICS; instead, use triple therapy LABA + LAMA + ICS.
✔✔What is the recommended treatment for Group E in COPD management? -
✔✔LABA + LAMA; consider adding ICS if blood eosinophils are 300 or greater.
✔✔What is the first-line treatment for exacerbations in COPD? - ✔✔SABA with or
without SAMA.
✔✔When should antibiotics be used in COPD exacerbations? - ✔✔When signs of
bacterial infection are present; azithromycin for 5 days.
✔✔What is the maximum duration for systemic corticosteroids during COPD
exacerbations? - ✔✔No more than 5 days.
✔✔What is the essential criterion for diagnosing Pulmonary Arterial Hypertension
(PAH)? - ✔✔Mean Pulmonary Artery pressure of 25 mmHg or higher.
