Overview of Respiratory Diseases
for NBRC TMC Exam Latest version
2026/2027
COPD - Chronic obstructive pulmonary disease characterized by progressive
dyspnea, chronic cough, sputum production, wheezing, and prolonged expiratory
phase.
Clinical Findings of COPD - Progressive dyspnea, chronic cough, sputum
production, wheezing, prolonged expiratory phase, accessory muscle use, barrel
chest (especially in emphysema), digital clubbing (late), decreased breath sounds,
hyperresonance on percussion.
CXR Findings of COPD - Flattened diaphragms, increased AP diameter,
hyperinflation, decreased vascular markings, bullae/blebs (emphysema).
Treatment for COPD - Smoking cessation, bronchodilators (SABA, LABA,
anticholinergics), inhaled corticosteroids, oxygen therapy (SpO2 88-92%), pulmonary
rehab, flu/pneumo vaccines, non-invasive ventilation for acute exacerbations
(BiPAP), ABG monitoring (look for compensated respiratory acidosis), consider lung
volume reduction or transplant in advanced cases.
Key Information for COPD - Chronic bronchitis = blue bloater; Emphysema = pink
puffer. GOLD staging based on FEV1. FEV1/FVC < 70%. Frequent exacerbations
due to infection. Avoid high oxygen (may reduce respiratory drive).
Asthma - A chronic condition characterized by episodic wheezing, dyspnea, chest
tightness, and cough, often triggered by allergens, cold air, exercise, infections, or
stress.
Clinical Findings of Asthma - Episodic wheezing, dyspnea, chest tightness, cough
(often at night), accessory muscle use, prolonged expiration.
CXR Findings of Asthma - Often normal between attacks. During attack:
hyperinflation, flattened diaphragm, peribronchial thickening.
, Treatment for Asthma - Stepwise approach: SABA (albuterol) PRN, ICS, LABA,
leukotriene modifiers. Acute: oxygen, SABA via SVN or MDI, systemic
corticosteroids, possible MgSO4 in severe cases, heliox in severe obstruction,
intubation if status asthmaticus.
Key Information for Asthma - Reversible airway obstruction. FEV1/FVC improves
post-bronchodilator. Peak flow monitoring critical. Status asthmaticus =
life-threatening, not responsive to standard treatment.
ARDS - Acute respiratory distress syndrome characterized by acute onset of severe
hypoxemia refractory to oxygen therapy.
Clinical Findings of ARDS - Acute onset (within 1 week of insult), severe hypoxemia
refractory to oxygen therapy, diffuse crackles, tachypnea, dyspnea, accessory
muscle use.
CXR Findings of ARDS - Diffuse bilateral alveolar infiltrates (ground-glass or
white-out appearance), normal heart size (to differentiate from cardiogenic
pulmonary edema).
Treatment for ARDS - Low tidal volume ventilation (4-6 mL/kg IBW), permissive
hypercapnia, high PEEP, prone positioning, treat underlying cause, fluid restriction,
consider ECMO if severe and refractory.
Key Information for ARDS - PaO2/FiO2 ratio < 300 = mild ARDS; < 200 = moderate;
< 100 = severe. Hallmark is refractory hypoxemia. Avoid volutrauma/barotrauma.
Use lung-protective strategies.
Pneumonia - An infection of the lungs characterized by fever, productive cough,
pleuritic chest pain, and crackles.
Clinical Findings of Pneumonia - Fever, productive cough, pleuritic chest pain,
crackles, bronchial breath sounds, increased tactile fremitus, egophony, dullness to
percussion.
CXR Findings of Pneumonia - Lobar consolidation, air bronchograms, possible
pleural effusion, patchy infiltrates in atypical pneumonia.
Treatment for Pneumonia - Empiric antibiotics based on setting (CAP, HAP, VAP),
oxygen therapy, bronchodilators if wheezing present, hydration, airway clearance
techniques if needed.
for NBRC TMC Exam Latest version
2026/2027
COPD - Chronic obstructive pulmonary disease characterized by progressive
dyspnea, chronic cough, sputum production, wheezing, and prolonged expiratory
phase.
Clinical Findings of COPD - Progressive dyspnea, chronic cough, sputum
production, wheezing, prolonged expiratory phase, accessory muscle use, barrel
chest (especially in emphysema), digital clubbing (late), decreased breath sounds,
hyperresonance on percussion.
CXR Findings of COPD - Flattened diaphragms, increased AP diameter,
hyperinflation, decreased vascular markings, bullae/blebs (emphysema).
Treatment for COPD - Smoking cessation, bronchodilators (SABA, LABA,
anticholinergics), inhaled corticosteroids, oxygen therapy (SpO2 88-92%), pulmonary
rehab, flu/pneumo vaccines, non-invasive ventilation for acute exacerbations
(BiPAP), ABG monitoring (look for compensated respiratory acidosis), consider lung
volume reduction or transplant in advanced cases.
Key Information for COPD - Chronic bronchitis = blue bloater; Emphysema = pink
puffer. GOLD staging based on FEV1. FEV1/FVC < 70%. Frequent exacerbations
due to infection. Avoid high oxygen (may reduce respiratory drive).
Asthma - A chronic condition characterized by episodic wheezing, dyspnea, chest
tightness, and cough, often triggered by allergens, cold air, exercise, infections, or
stress.
Clinical Findings of Asthma - Episodic wheezing, dyspnea, chest tightness, cough
(often at night), accessory muscle use, prolonged expiration.
CXR Findings of Asthma - Often normal between attacks. During attack:
hyperinflation, flattened diaphragm, peribronchial thickening.
, Treatment for Asthma - Stepwise approach: SABA (albuterol) PRN, ICS, LABA,
leukotriene modifiers. Acute: oxygen, SABA via SVN or MDI, systemic
corticosteroids, possible MgSO4 in severe cases, heliox in severe obstruction,
intubation if status asthmaticus.
Key Information for Asthma - Reversible airway obstruction. FEV1/FVC improves
post-bronchodilator. Peak flow monitoring critical. Status asthmaticus =
life-threatening, not responsive to standard treatment.
ARDS - Acute respiratory distress syndrome characterized by acute onset of severe
hypoxemia refractory to oxygen therapy.
Clinical Findings of ARDS - Acute onset (within 1 week of insult), severe hypoxemia
refractory to oxygen therapy, diffuse crackles, tachypnea, dyspnea, accessory
muscle use.
CXR Findings of ARDS - Diffuse bilateral alveolar infiltrates (ground-glass or
white-out appearance), normal heart size (to differentiate from cardiogenic
pulmonary edema).
Treatment for ARDS - Low tidal volume ventilation (4-6 mL/kg IBW), permissive
hypercapnia, high PEEP, prone positioning, treat underlying cause, fluid restriction,
consider ECMO if severe and refractory.
Key Information for ARDS - PaO2/FiO2 ratio < 300 = mild ARDS; < 200 = moderate;
< 100 = severe. Hallmark is refractory hypoxemia. Avoid volutrauma/barotrauma.
Use lung-protective strategies.
Pneumonia - An infection of the lungs characterized by fever, productive cough,
pleuritic chest pain, and crackles.
Clinical Findings of Pneumonia - Fever, productive cough, pleuritic chest pain,
crackles, bronchial breath sounds, increased tactile fremitus, egophony, dullness to
percussion.
CXR Findings of Pneumonia - Lobar consolidation, air bronchograms, possible
pleural effusion, patchy infiltrates in atypical pneumonia.
Treatment for Pneumonia - Empiric antibiotics based on setting (CAP, HAP, VAP),
oxygen therapy, bronchodilators if wheezing present, hydration, airway clearance
techniques if needed.
