The only antileukotriene agent currently approved for use in pediatric patients is:
C) Singulair
Zileuton interacts with which of the following respiratory care drugs?
I. Theophylline
II. Albuterol
III. Warfarin
IV. Ipratropium bromide
V. Beclomethasone
I and III only
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:
C) add a spacer and rinse the mouth after use
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.
I, II, III, IV, and V
The term used to describe surfactant produced outside of the patient's body is:
A) exogenous
Surfactant is stored in:
A) alveoli.
B) Type II alveolar cells.
C) lamellar bodies.
D) lipids.
C) 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
I, II, III, and IV
Which of the following nonsteroidal antiasthma agents is formulated as an MDI?
A) Zileuton
B) Nedocromil
C) Montelukast
D) Zafirlukast
B) Nedocromil
Which type of asthma is associated with allergic reactions?
A) Chronic
B) Intrinsic
C) Acute
D) Extrinsic
D) Extrinsic
Which drug is a lipid-soluble, intracellular receptor agonist that prevents an inflammatory response?
A) Singulair
B) Zyflo
C) Xolair
D) Flovent
D) Flovent
All the following are considered natural surfactants except:
A) Beractant.
B) Calfactant.
C) Dornase alfa.
D) Poractant alfa.
C) Dornase alfa.
The brand name for cromolyn sodium is:
A) Tilade
B) Accolate
C) Intal
D) Singulair
C) Intal
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) Albuterol
C) Beractant
D) Solu-Medrol
C) 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) Albuterol
C) Beractant
D) No indication for drug therapy at this time
D) No indication for drug therapy at this time
Which of the following are examples of steroids available for inhalation?
I. Flunisolide
II. Azmacort
III. QVAR
IV. Interleukin
I, II, and III only
Which of the following are natural surfactant preparations?
I. Surfaxin
II. Curosurf
III. Survanta
IV. Infasurf
II, III and IV
Another name for surface-active agents is:
A) mucolytic.
B) detergent.
C) bronchodilator.
D) antibiotic.
B) 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
D) Chloride
Which of the following is considered the mode of action for surfactant?
A) To replace missing surfactant.
B) To accelerate lung maturity.
C) To emulsify lung secretions.
D) To relax bronchial smooth muscle.
A) To replace missing surfactant.
The product combining an inhaled steroid and a bronchodilator is:
A) Azmacort.
B) Flovent.
C) Advair.
D) QVAR.
C) Advair.
Side effects of systemic steroid treatment include which of the following?
I. HPA suppression
II. Cough
III. Dysphonia
IV. Psychiatric reactions
I and IV only
The usual method of administering exogenous surfactant to babies is:
A) direct instillation to the airway.
B) nebulization.
C) intravenously.
D) rectal suppository.
A) direct instillation to the airway.
A significant side effect of corticosteroid use is inhibition of:
A) IgE.
B) PGE.
C) HPA axis.
D) SRS-A.
C) HPA axis.
Cromolyn sodium is available in all of the following forms except:
A) Nebulizer solution
B) Tablet
C) MDI
D) Nasal spray
B) Tablet
Which of the following are antileukotrienes?
I. Zafirlukast
II. Zileuton
III. Cromolyn sodium
IV. Montelukast
V. Nedocromil sodium
I, II, and IV only
Which of the following is considered a mast cell stabilizer?
A) Montelukast
B) Zafirlukast
C) Cromolyn sodium
D) Zileuton
C) Cromolyn sodium
Advantages to the use of antileukotrienes include all of the following except:
A) oral administration.
B) additive effect with inhaled steroids.
C) effective in more than 90% of patients.
D) a formulation available for pediatric use.
C) effective in more than 90% of patients.
The usual dose of nebulized cromolyn sodium is:
A) 10 mg four times per day.
B) 20 mg four times per day.
C) 30 mg three times per day.
D) 80 mg three times per day.
B) 20 mg four times per day.
The most commonly reported side effect of cromolyn sodium is:
A) diarrhea.
B) pneumonia.
C) nasal congestion.
D) headache.
C) nasal congestion.
Which of the following is a monoclonal antibody used to treat asthma?
A) Omalizumab
B) Zileuton
C) Nedocromil
D) Montelukast
A) Omalizumab
The inflammatory process includes which of the following activities?
I. Mediator cascade
II. Increased vascular permeability
III. Leukocytic infiltration
IV. Phagocytosis
I, II, III, and IV
For an alveolus, LaPlace's Law is written as:
A) Pressure = ( 4 x surface tension)/radius
B) dyn/cm
C) Pressure = surface tension/radius
D) Pressure = (2 x surface tension)/radius
D) Pressure = (2 x surface tension)/radius
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) Ipratropium bromide.
B) Poractant alfa.
C) Salmeterol.
D) Dornase alfa.
B) Poractant alfa.
What is the clinical indication for use of leukotriene modifiers, such as montelukast, in asthma?
A) As a rescue bronchodilator in step 1 asthma.
B) As a long-acting bronchodilator in step 3 asthma.
C) As an alternative to, or in combination with, inhaled steroids.
D) As a mast cell stabilizer.
C) As an alternative to, or in combination with, inhaled steroids.
The major stimulus for secretion of surfactant into the alveolus is:
A) lung inflation.
B) lung deflation.
C) cough.
D) infection.
A) lung inflation.
Natural surfactant is obtained by all of the following methods except:
A) amniotic fluid extraction.
B) in vitro preparation.
C) human alveolar wash.
D) animal alveolar wash.
B) in vitro preparation.
In chronic obstructive pulmonary disease (COPD., the primary inflammatory cells are:
A) eosinophils.
B) T lymphocytes.
C) macrophages.
D) neutrophils.
D) neutrophils.
Nedocromil sodium is administered by:
A) DPI.
B) tablet.
C) MDI
D) nebulizer
C) MDI
The rise and fall of levels of glucocorticoids in the body follows what kind of rhythm?
A) Weekly
B) Monthly
C) Circadian
D) No set rhythm
C) Circadian
Zafirlukast is a:
A) leukotriene receptor stimulator.
B) leukotriene receptor antagonist.
C) Adrenergic.
D) corticosteroid.
B) leukotriene receptor antagonist.
The major cells responsible for an inflammatory response in asthma are:
A) macrophages and mast cells.
B) mast cells and eosinophils.
C) T lymphocytes and macrophages.
D) basophils and SRS-A.
B) mast cells and eosinophils.
All of the following are types of corticosteroids produced in the adrenal cortex except:
A) glucocorticoids.
B) corticotropin-releasing factor.
C) mineralocorticoids.
D) sex hormones.
B) corticotropin-releasing factor.
Surfactant is composed primarily of:
A) proteins.
B) phospholipids.
C) neutral lipids.
D) water.
B) phospholipids.
All the following are hazards or complications of exogenous surfactant except:
A) airway occlusion.
B) overoxygenation.
C) tachycardia.
D) pulmonary insult via barotraumas.
C) tachycardia.
Corticosteroids normally produced by the body are known as:
A) endogenous.
B) exogenous.
C) extrinsic.
D) intrinsic.
A) endogenous.
The general indication for clinical use of nonsteroidal antiasthma agents is:
A) short-term control of bronchospasm.
B) prophylactic management of mild persistent asthma.
C) long-term control of bronchospasm.
D) control of severe asthma attack.
B) prophylactic management of mild persistent asthma.
Side effects of aerosolized steroid use include all of the following except:
A) cough.
B) osteoporosis.
C) dysphonia.
D) oral thrush.
B) osteoporosis.
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
I, II, and III only
Lack of pulmonary surfactant in respiratory distress syndrome of the newborn results in:
A) high surface tension.
B) low surface tension.
C) no effect on surface tension.
D) increased compliance.
A) high surface tension
Surfactant is produced by:
A) alveolar type II cells.
B) goblet cells.
C) alveolar type I cells.
D) macrophages.
