BIO142

The only antileukotriene agent currently approved for use in pediatric patients is:

A) Singulair.
B) Accolate.
C) Tilade.
D) Intal.

Zileuton interacts with which of the following respiratory care drugs?
I. Theophylline
II. Albuterol
III. Warfarin
IV. Ipratropium bromide
V. Beclomethasone

A patient complains of oral thrush and hoarseness since she has been using fluticasone by MDI. The physician asks you to make a suggestion to help her without discontinuing the drug. You suggest:

A) add a spacer and rinse the mouth after use.
B) pause 5 minutes between puffs.
C) switch to a DPI.
D) inhale with a higher inspiratory flow rate.

Leukotrienes exhibit which of the following effects?
I. Increased mucus secretion.
II. Inhibition of normal ciliary action.
III. Increased airway edema.
IV. Bronchoconstriction
V. Recruitment of other inflammatory cells into airways.

The term used to describe surfactant produced outside of the patient's body is:

A) exogenous.
B) endogenous.
C) bovine
D) natural.

Surfactant is stored in:

A) alveoli.
B) lipids.
C) Type II alveolar cells.
D) lamellar bodies.

Tilade is effective as an antiinflammatory by inhibiting activation and activity of which of the following?
I. Sensory neurons
II. Mast cells
III. Airway epithelial cells
IV. Eosinophils

Which of the following nonsteroidal antiasthma agents is formulated as an MDI?

A) Montelukast
B) Nedocromil
C) Zafirlukast
D) Zileuton

Which type of asthma is associated with allergic reactions?

A) Extrinsic
B) Intrinsic
C) Acute
D) Chronic

Which drug is a lipid-soluble, intracellular receptor agonist that prevents an inflammatory response?

A) Flovent
B) Xolair
C) Singulair
D) Zyflo

All the following are considered natural surfactants except:

A) Beractant.
B) Dornase alfa.
C) Calfactant.
D) Poractant alfa.

The brand name for cromolyn sodium is:

A) Singulair
B) Intal
C) Accolate
D) Tilade

You are in the room of a 26-week gestational baby that has just been born. The newborn weighs 1200 g. On assessment you find the baby has poor color, substernal retractions, nasal flaring, a RR of 45 breaths/min, and a HR of 140 beats/min. You note that the baby is difficult to bag. Which of the following agents would you recommend?

A) Cromolyn sodium
B) Solu-Medrol
C) Albuterol
D) Beractant

You are in the room of a 36-week gestational baby that has just been born. The newborn weighs 2200 g. On assessment you find the baby has good color, no retractions, no nasal flaring, a respiratory rate (RR) of 25 breaths/min, a heart rate (HR) of 110 beats/min, and pulse-ox of 96% on room air. Which of the following would you choose?

A) Calfactant
B) No indication for drug therapy at this time
C) Beractant
D) Albuterol

Which of the following are examples of steroids available for inhalation?
I. Flunisolide
II. Azmacort
III. QVAR
IV. Interleukin

Which of the following are natural surfactant preparations?
I. Surfaxin
II. Curosurf
III. Survanta
IV. Infasurf

Another name for surface-active agents is:

A) antibiotic.
B) mucolytic.
C) bronchodilator.
D) detergent.

It has been suggested that Intal and Tilade are effective as antiinflammatory agents by blocking transport of what ion into inflammatory cells?

A) Sodium
B) Potassium
C) Bicarbonate
D) Chloride

Which of the following is considered the mode of action for surfactant?

A) To accelerate lung maturity.
B) To emulsify lung secretions.
C) To replace missing surfactant.
D) To relax bronchial smooth muscle.

The product combining an inhaled steroid and a bronchodilator is:

A) Azmacort.
B) Flovent.
C) QVAR.
D) Advair.

Side effects of systemic steroid treatment include which of the following?

I. HPA suppression
II. Cough
III. Dysphonia
IV. Psychiatric reactions

The usual method of administering exogenous surfactant to babies is:

A) intravenously.
B) direct instillation to the airway.
C) nebulization.
D) rectal suppository.

A significant side effect of corticosteroid use is inhibition of:

A) HPA axis.
B) IgE.
C) PGE.
D) SRS-A.

Cromolyn sodium is available in all of the following forms except:

A) Nasal spray
B) MDI
C) Nebulizer solution
D) Tablet

Which of the following are antileukotrienes?

I. Zafirlukast
II. Zileuton
III. Cromolyn sodium
IV. Montelukast
V. Nedocromil sodium

Which of the following is considered a mast cell stabilizer?

A) Zileuton
B) Cromolyn sodium
C) Montelukast
D) Zafirlukast

Advantages to the use of antileukotrienes include all of the following except:

A) a formulation available for pediatric use.
B) additive effect with inhaled steroids.
C) effective in more than 90% of patients.
D) oral administration.

The usual dose of nebulized cromolyn sodium is:

A) 10 mg four times per day.
B) 80 mg three times per day.
C) 20 mg four times per day.
D) 30 mg three times per day.

The most commonly reported side effect of cromolyn sodium is:

A) headache.
B) diarrhea.
C) nasal congestion.
D) pneumonia.

Which of the following is a monoclonal antibody used to treat asthma?

A) Zileuton
B) Nedocromil
C) Omalizumab
D) Montelukast

The inflammatory process includes which of the following activities?

I. Mediator cascade
II. Increased vascular permeability
III. Leukocytic infiltration
IV. Phagocytosis

For an alveolus, LaPlace's Law is written as:

A) Pressure = surface tension/radius
B) Pressure = ( 4 x surface tension)/radius
C) Pressure = (2 x surface tension)/radius
D) dyn/cm

A newborn baby weighing 1000 g exhibits symptoms of respiratory distress syndrome (RDS), including poor color, suprasternal retractions, nasal flaring, and desaturation. The therapist should recommend:

A) Poractant alfa.
B) Ipratropium bromide.
C) Dornase alfa.
D) Salmeterol.

What is the clinical indication for use of leukotriene modifiers, such as montelukast, in asthma?

A) As a long-acting bronchodilator in step 3 asthma.
B) As a mast cell stabilizer.
C) As an alternative to, or in combination with, inhaled steroids.
D) As a rescue bronchodilator in step 1 asthma.

The major stimulus for secretion of surfactant into the alveolus is:

A) lung inflation.
B) lung deflation.
C) cough.
D) infection.

Natural surfactant is obtained by all of the following methods except:

A) in vitro preparation.
B) animal alveolar wash.
C) amniotic fluid extraction.
D) human alveolar wash.

In chronic obstructive pulmonary disease (COPD., the primary inflammatory cells are:

A) eosinophils.
B) neutrophils.
C) T lymphocytes.
D) macrophages.

Nedocromil sodium is administered by:

A) DPI.
B) tablet.
C) MDI
D) nebulizer

The rise and fall of levels of glucocorticoids in the body follows what kind of rhythm?

A) No set rhythm
B) Circadian
C) Weekly
D) Monthly

Zafirlukast is a:

A) leukotriene receptor stimulator.
B) Adrenergic.
C) leukotriene receptor antagonist.
D) corticosteroid.

The major cells responsible for an inflammatory response in asthma are:

A) basophils and SRS-A.
B) macrophages and mast cells.
C) T lymphocytes and macrophages.
D) mast cells and eosinophils.

All of the following are types of corticosteroids produced in the adrenal cortex except:

A) mineralocorticoids.
B) glucocorticoids.
C) sex hormones.
D) corticotropin-releasing factor.

Surfactant is composed primarily of:

A) phospholipids.
B) neutral lipids.
C) water.
D) proteins.

All the following are hazards or complications of exogenous surfactant except:

A) pulmonary insult via barotraumas.
B) overoxygenation.
C) tachycardia.
D) airway occlusion.

Corticosteroids normally produced by the body are known as:

A) endogenous.
B) extrinsic.
C) exogenous.
D) intrinsic.

The general indication for clinical use of nonsteroidal antiasthma agents is:

A) short-term control of bronchospasm.
B) long-term control of bronchospasm.
C) prophylactic management of mild persistent asthma.
D) control of severe asthma attack.

Side effects of aerosolized steroid use include all of the following except:

A) oral thrush.
B) osteoporosis.
C) dysphonia.
D) cough.

Which of the following are approved indications for surfactant therapy?

I. Prophylaxis in very low birth weight (<1250 g) infants
II. Prophylaxis in infants of higher birth weight (>1250 g) but with immature lungs
III. Rescue treatment in infants with respiratory distress syndrome
IV. Acute respiratory distress syndrome in the adult

Lack of pulmonary surfactant in respiratory distress syndrome of the newborn results in:

A) low surface tension.
B) increased compliance.
C) no effect on surface tension.
D) high surface tension.

Surfactant is produced by:

A) goblet cells.
B) alveolar type I cells.
C) macrophages.
D) alveolar type II cells.