Respi

Respiratory Cme

By Alpha team

Multiple Choice

The bronchodilatory effect of intravenous magnesium sulfate in acute severe asthma is mainly due to:

• Blocking muscarinic receptors

• Inhibiting calcium influx into smooth muscle cells

• Increasing histamine release from mast cells

• Stimulating β₁ receptors in the heart

Multiple Choice

According to GINA 2024, which of the following is the preferred reliever therapy for adults and adolescents with asthma?

• Short-acting β₂ agonist (SABA) alone

• ICS-formoterol

• Oral theophylline

• Nebulized ipratropium bromide

Multiple Choice

Which of the following mediators is NOT typically released from mast cells during acute allergic bronchoconstriction in asthma?

• Histamine

• Leukotrienes

• Tryptase

• Acetylcholine

Multiple Choice

In acute asthma, a normal or slightly elevated PaCO₂ is most concerning for:

• Hyperventilation due to anxiety

• Resolution of bronchospasm

• Extreme airway obstruction and impending ventilatory failure

• Metabolic alkalosis

Multiple Choice

Why is oxygen-driven nebulization preferred in children with acute asthma?

• It prevents hypoxemia during nebulization

• It increases drug particle size for better deposition

• It reduces the need for corticosteroids

• It prevents rebound bronchospasm

Multiple Choice

Which of the following is a hallmark feature of COPD?

• Fully reversible airflow obstruction

• Persistent, progressive airflow limitation

• Acute airway swelling only

• Absence of sputum production

Multiple Choice

In mild COPD exacerbation, initial management involves:

• LABA only

• SABA only

• SABA + oral corticosteroids

• Oxygen + aminophylline

Multiple Choice

Which patients should receive antibiotics during a COPD exacerbation?

• Any patient with cough

• Only those with fever

• Those with increased dyspnoea, sputum volume, and sputum purulence or requiring mechanical

• All admitted COPD patients

Multiple Choice

IV magnesium sulfate benefits COPD patients during exacerbations primarily by:

A. Stimulating beta-2 receptors

• Stimulating beta-2 receptors

• Inhibiting calcium influx into airway smooth muscle

• Reducing mucus production

• Increasing alveolar surfactant secretion

Multiple Choice

In a COPD exacerbation, mechanical ventilation is indicated when:

• pO2 drops below 90%

• Hypercapnia is associated with depressed mental status, severe acidemia, or arrhythmias

• PaO2 is less than 60 mmHg

• FEV1 is < 30% predicted

Multiple Choice

In a normal upright lung, which West zone has the highest V/Q ratio?

• Zone 1 (apex)

• Zone 2 (mid-lung)

• Zone 3 (base)

• D. All zones have equal V/Q

Multiple Choice

Which of the following changes is MOST likely in the apex (Zone 1) of the lung compared to the base (Zone 3)?

• Higher alveolar PO2 and lower PCO2

• Lower alveolar PO2 and higher PCO2

• Equal alveolar gas values in all zones

• Higher perfusion than ventilation

Multiple Choice

In V/Q mismatch, hypoxemia occurs primarily because of:

• Reduced hemoglobin concentration

• Uneven distribution of ventilation and perfusion

• Increased diffusion distance across the alveolar-capillary membrane

• Increased metabolic oxygen consumption

Multiple Choice

A patient with lobar pneumonia has an area of lung that is perfused but poorly ventilated. Which of the following best describes the V/Q ratio in this region?

• V/Q = 0 (true shunt)

• V/Q < 1 (shunt-like)

• V/Q = 1 (normal)

• V/Q > 1 (dead space)

Thank you

Multiple Choice

Which of the following is TRUE regarding dead space ventilation?

• Occurs when perfusion is absent

• Alveolar PO2 equals inspired PO2

• Often caused by pulmonary embolism

• All of the above