WorksheetsObstructive Lung Disease
Total questions: 29
Worksheet time: 32mins
Refer to the diagram titled “The Lungs and COPD.” Which anatomical structure is the primary site of gas exchange that becomes enlarged with air trapping in emphysema?
Trachea
Bronchial tubes
Bronchioles
Alveoli
In the chronic bronchitis inset, what combination of changes narrows the airway?
Relaxed smooth muscles and reduced mucus
Tightened smooth muscles and increased mucus
Dilated smooth muscles and decreased airflow
Reduced cilia motion and alveolar collapse
Explain how anatomical changes in emphysema and chronic bronchitis contribute to airflow limitation in COPD.
Recall the key spirometric indicator of obstructive lung disease. Which finding best supports the diagnosis?
Increased FVC with normal FEV1/FVC ratio
Reduced FEV1/FVC ratio below 70%
Elevated FEV1 with decreased FVC
Normal FEV1/FVC ratio with reduced TLC
A patient has difficulty exhaling and demonstrates a prolonged expiratory phase. Which pathophysiologic consequence most likely accompanies these features?
Reduced residual volume due to enhanced emptying
Air trapping leading to hyperinflation
Improved ventilatory efficiency with lower dead space
Restrictive pattern with increased FEV1/FVC ratio
Explain how airflow limitation manifests during expiration and how it affects the FEV1/FVC ratio.
Recall the list of common obstructive lung conditions shown in the diagram: Asthma; Chronic Bronchitis; Emphysema; Cystic Fibrosis (less common in adults). Which condition in this list is noted as less common in adults?
Asthma
Chronic Bronchitis
Emphysema
Cystic Fibrosis
Match each obstructive lung condition to a concise distinguishing note based solely on the diagram’s emphasis. Use one-to-one matching.
Asthma
Airway hyperreactivity condition
Chronic Bronchitis
Persistent productive airway inflammation
Emphysema
Alveolar destruction leading obstruction
Cystic Fibrosis
Genetic disease; less common in adults
According to the Asthma Overview, which feature best distinguishes asthma from fixed obstructive diseases?
Irreversible airway narrowing
Reversible airway obstruction
Alveolar wall destruction
Chronic productive cough for ≥3 months/year
Which set of triggers is most consistent with asthma as described?
Airborne allergens, respiratory infections, exercise, and cold air
High altitude, dehydration, and heat exposure
Bacterial pneumonia and pleural effusion
Long-term tobacco use only
Define chronic bronchitis using the time-based diagnostic criterion.
Which statement best characterizes emphysema pathology in this overview?
Bronchial smooth muscle constriction causes reversible obstruction
Excess mucus leads to chronic productive cough
Destruction of alveolar walls and capillary beds leads to loss of elastic recoil and hyperinflation with minimal sputum
Viral infection of the bronchi causes acute airway edema
Explain why emphysema leads to hyperinflation (“air trapping”).
Which exposure is most commonly associated with the development of chronic bronchitis in this overview?
Seasonal pollen alone
Occupational and environmental irritants or smoking
Genetic alpha-1 antitrypsin deficiency exclusively
Cold air during exercise
DoK 1 — Which statement best characterizes asthma based on the provided comparison?
Late onset, progressive disease, neutrophilic inflammation, partial bronchodilator response
Early onset, reversible airway obstruction, eosinophilic inflammation, strong bronchodilator response
Early onset, irreversible airflow limitation, neutrophilic inflammation, weak bronchodilator response
Late onset, reversible airflow obstruction, eosinophilic inflammation, strong bronchodilator response
DoK 1 — According to the comparison, which feature distinguishes COPD from asthma?
Strong bronchodilator response
Eosinophilic-predominant inflammation
Progressive course with partial bronchodilator response
Early onset with reversible obstruction
DoK 3 — A 22-year-old with intermittent wheeze shows near-complete reversal of airflow limitation after albuterol. What diagnosis is most consistent in this reversal and what aspect of the response supports it?
Pulmonary function testing in obstructive lung disease typically shows which combination of changes?
Decreased FEV1, decreased FEV1/FVC ratio, increased RV, increased TLC
Decreased FEV1, increased FEV1/FVC ratio, decreased RV, decreased TLC
Increased FEV1, decreased FEV1/FVC ratio, decreased RV, increased TLC
Increased FEV1, increased FEV1/FVC ratio, increased RV, decreased TLC
Which single parameter best distinguishes obstructive from restrictive patterns on spirometry when FEV1 is reduced?
Total lung capacity (TLC)
Residual volume (RV)
FEV1/FVC ratio
Arterial oxygen saturation
Match each stage in arterial blood gas (ABG) patterns with the characteristic finding in obstructive lung disease.
Early stage
Respiratory alkalosis
Chronic stage
Compensated respiratory acidosis
Severe stage
Hypoxemia with hypercapnia
A patient with chronic obstructive lung disease presents with ABGs showing a near‑normal pH with elevated PaCO2 and increased HCO3−. Which pattern does this most likely represent?
Early respiratory alkalosis
Compensated respiratory acidosis
Metabolic alkalosis
Severe hypoxemia with hypercapnia
Which chest radiograph finding is most characteristic of obstructive lung disease due to hyperinflation?
Flattened diaphragms
Pleural effusion
Lobar consolidation
Mediastinal widening
Which respiratory therapy intervention is specifically noted to be delivered at low flow for CO2 retainers?
Bronchodilators
Corticosteroids
Oxygen therapy
Airway clearance
Match each respiratory therapy intervention to its primary purpose.
Bronchodilators
Relax airway smooth muscle to reduce bronchospasm
Corticosteroids
Decrease airway inflammation
Airway clearance
Mobilize and remove secretions
Noninvasive ventilation (BiPAP)
Support ventilation without an endotracheal tube
Which patient education topic most directly supports long-term functional improvement through supervised exercise and behavior change programs?
Proper inhaler technique
Smoking cessation
Pulmonary rehab
Breathing exercises
Refer to the case image showing a 65-year-old COPD patient with ABG values listed as 7.32 / 60 / 55 / 30. Which interpretation best fits these results?
Uncompensated metabolic acidosis
Compensated respiratory acidosis
Acute respiratory alkalosis
Fully corrected acid-base status
Using the ABG sequence (pH 7.32 PaCO2 60 PaO2 55 HCO3 30), briefly explain how these numbers support a diagnosis of compensated respiratory acidosis in a COPD patient.
DoK 1 — Which statement best characterizes obstructive lung diseases according to the summary?
They primarily involve restrictive mechanics with reduced lung compliance.
They are defined by airflow limitation in the airways.
They present with normal spirometry but abnormal imaging.
They are caused exclusively by infectious agents.
DoK 3 — A patient presents with worsening dyspnea and chronic cough. Outline a strategic initial management plan using the section’s key takeaways, specifying how diagnostics and therapeutic priorities guide care.
