Pathophysiology Focus in Chronic Respiratory Conditions - Respiratory Therapist Reviewer

A comprehensive understanding of pathophysiology is crucial for respiratory therapists preparing for the board exam. Chronic respiratory conditions, including Chronic Obstructive Pulmonary Disease (COPD) and asthma, are key topics that candidates must master. Effective management strategies, long-term treatment options, and home-based respiratory care are central to patient outcomes.

Management of Chronic Conditions (COPD and Asthma)
For COPD, understanding disease progression, pathophysiological changes such as alveolar damage, and airway inflammation is essential. Management involves pharmacological treatments like bronchodilators, corticosteroids, and mucolytics, as well as non-pharmacological interventions like pulmonary rehabilitation and smoking cessation.

Asthma management requires familiarity with the mechanisms of airway hyperresponsiveness and inflammation. Candidates must understand the classification of asthma severity and control, as well as the appropriate use of long-acting beta-agonists (LABAs), inhaled corticosteroids, and leukotriene receptor antagonists. Emphasis on patient education and adherence to asthma action plans is critical for exam success.

Long-Term Oxygen Therapy (LTOT) and Home Ventilation
The use of LTOT is a vital topic, especially for patients with severe hypoxemia due to COPD or interstitial lung diseases. Candidates must be familiar with criteria for initiating oxygen therapy, device selection (concentrators and portable oxygen systems), and monitoring techniques to prevent complications such as oxygen toxicity.

Home ventilation is another crucial component, particularly for patients with neuromuscular diseases or severe chronic respiratory conditions. Understanding the indications for non-invasive ventilation (NIV) and the setup of ventilatory devices at home, including pressure and volume settings, is essential for proper management.

RESPIRATORY THERAPIST REVIEWER

Welcome to our Respiratory Therapist Reviewer. In this session, you'll have the opportunity to test your understanding of key concepts in Chronic Respiratory Conditions. The quiz consists of multiple-choice questions covering various topics. Pay close attention to each question and select the best answer. After completing the exam, check the video or the answer key and explanations at the last part.

Chronic Obstructive Pulmonary Disease (COPD) and Asthma

1. Which pulmonary function test finding is characteristic of obstructive lung disease?

A. Decreased FEV₁/FVC ratio

B. Increased total lung capacity (TLC)

C. Decreased residual volume (RV)

D. Increased diffusing capacity (DLCO)

2. Which of the following statements about asthma is TRUE?

A. Asthma is primarily a restrictive lung disease.

B. Asthma symptoms are usually irreversible.

C. Asthma is characterized by airway hyperresponsiveness.

D. Asthma is primarily caused by smoking.

3. Which is the most effective intervention for reducing COPD mortality?

A. Long-acting beta-agonists (LABA)

B. Smoking cessation

C. Inhaled corticosteroids

D. Pulmonary rehabilitation

4. Which of the following medications is NOT recommended as a first-line treatment for stable COPD?

A. Long-acting muscarinic antagonists (LAMA)

B. Long-acting beta-agonists (LABA)

C. Inhaled corticosteroids (ICS)

D. Systemic corticosteroids

5. Which of the following is a feature of severe COPD?

A. Chronic productive cough

B. Barrel chest

C. Increased FEV₁

D. Hyperoxia

6. Which of the following is the most common risk factor for COPD?

A. Smoking

B. Air pollution

C. Occupational exposure

D. Genetic predisposition

7. Which of the following findings is characteristic of emphysema?

A. Increased mucus production

B. Destruction of alveolar walls

C. Reversible bronchoconstriction

D. Interstitial fibrosis

8. What is the primary goal of oxygen therapy in COPD patients?

A. Normalize oxygen saturation to 100%

B. Reduce carbon dioxide levels

C. Maintain PaO₂ at 55-60 mmHg

D. Increase respiratory rate

9. Which medication is the first-line treatment for stable COPD?

A. Inhaled corticosteroids

B. Long-acting beta-agonists (LABA)

C. Short-acting beta-agonists (SABA)

D. Anticholinergics

10. Which test is required to diagnose COPD?

A. Arterial blood gas (ABG)

B. Chest X-ray

C. Spirometry

D. Peak expiratory flow rate

11. Which of the following is NOT a typical asthma trigger?

A. Dust mites

B. Cold air

C. Smoking

D. Pulmonary embolism

12. Which medication is the mainstay of long-term asthma control?

A. Short-acting beta-agonists (SABA)

B. Inhaled corticosteroids

C. Leukotriene receptor antagonists

D. Oral corticosteroids

13. Which of the following is a sign of severe asthma exacerbation?

A. Wheezing

B. Silent chest

C. Mild dyspnea

D. Productive cough

14. Which value is used to assess asthma severity?

A. FEV₁

B. Total lung capacity (TLC)

C. Diffusing capacity (DLCO)

D. Inspiratory reserve volume

15. Which step is recommended for a patient with asthma who requires rescue inhalers multiple times per week?

A. Increase SABA dose

B. Add inhaled corticosteroids

C. Start oral corticosteroids

D. No changes needed

Long-Term Oxygen Therapy (LTOT) and Home Ventilation

16. Which of the following patients would benefit most from long-term oxygen therapy (LTOT)?

A. COPD patient with PaO₂ of 65 mmHg

B. COPD patient with mild dyspnea on exertion

C. COPD patient with PaO₂ < 55 mmHg

D. COPD patient with FEV₁ < 80% but normal PaO₂

17. Which is the most appropriate oxygen delivery system for home use in a COPD patient with chronic hypoxemia?

A. Venturi mask

B. Non-rebreather mask

C. Nasal cannula

D. Bag-valve-mask ventilation

18. What is the primary goal of BiPAP therapy in chronic respiratory failure?

A. Increase oxygen saturation to 100%

B. Increase total lung capacity

C. Reduce oxygen dependency

D. Improve alveolar ventilation and CO₂ elimination

19. Which is an indication for long-term oxygen therapy in COPD patients?

A. PaO₂ < 80 mmHg

B. PaO₂ < 55 mmHg

C. FEV₁ < 50%

D. Peak flow < 250 L/min

20. What is the target SpO₂ for COPD patients on long-term oxygen therapy?

A. 85-90%

B. 92-96%

C. 88-92%

D. >98%

21. Which mode of ventilation is preferred for home management of COPD with chronic hypercapnia?

A. Invasive mechanical ventilation

B. High-flow nasal cannula

C. Non-invasive positive pressure ventilation (NIPPV)

D. Continuous mandatory ventilation

22. Which condition is an indication for home mechanical ventilation?

A. Mild COPD

B. Severe obstructive sleep apnea

C. Pneumonia

D. Acute asthma exacerbation

Pulmonary Rehabilitation and Patient Management

23. Which component is NOT included in pulmonary rehabilitation programs?

A. Exercise training

B. Smoking cessation counseling

C. Long-term corticosteroid therapy

D. Nutritional support

24. Which breathing technique is most effective for COPD patients to reduce dyspnea?

A. Diaphragmatic breathing

B. Shallow breathing

C. Breath-holding

D. Rapid breathing

25. Which vaccination is recommended for all COPD patients?

A. Tuberculosis vaccine

B. Influenza and pneumococcal vaccines

C. Hepatitis B vaccine

D. Rotavirus vaccine

Additional Questions

26. What is the primary cause of airway obstruction in COPD?

A. Alveolar hyperinflation

B. Bronchial hyperreactivity

C. Mucus plugging and airway remodeling

D. Pulmonary fibrosis

27. Which of the following conditions is a restrictive lung disease?

A. COPD

B. Asthma

C. Pulmonary fibrosis

D. Bronchiectasis

28. Which factor predicts mortality in COPD patients?

A. Age

B. BMI

C. FEV₁

D. Smoking history

29. Which structure is affected in emphysema?

A. Alveoli

B. Bronchi

C. Pleura

D. Pulmonary artery

30. Which of the following is a side effect of long-term corticosteroid use in asthma?

A. Osteoporosis

B. Hypoglycemia

C. Weight loss

D. Hypotension

ANSWER KEY HERE