Lack of pulmonary surfactant in respiratory distress syndrome of the newborn results in:
D. high surface tension
The term used to describe surfactant produced outside of the patient's body is:
D. exogenous
Surfactant is produced by:
C. alveolar type II cells
Surfactant is composed primarily of :
D. phospholipids
Surfactant is stored in:
B. lamellar bodies
The major stimulus for secretion of surfactant into the alveolus is:
B. lung inflation
Which of the following are natural surfactant preparations?
I. surfaxin
II. curosurf
III. survanta
IV. infasurf
A. II, III, and IV
Natural surfactant is obtained by all of the following methods except:
D. in vitro preparation
Which of the following are approved indications for surfactant therapy?
I. prophylaxis in very low birth wight (<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
D. I, II, and III only
Which of the following are currently used methods for delivering surfactant into infants?
I. instillation through side-port catheter
II. instillation through catheter
III. nebulization
IV. ECMO
D. I and II only
You are in the room of a 36-week gestationa 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 RR of 25, a HR of 110, and a pulse-ox of 96% on room air. Which of the following would you choose?
B. no indication for therapy at this time
A newborn baby weighing 1000 g exhibits symptoms of RDS, including poor color, suprasternal retractions, nasal flaring, and desaturations. The therapist should recommend:
C. poractant alfa
All the following are considered natural surfactants except:
C. dornase alfa
The usual method of administering exogenous surfactant to babies is:
B. direct instillation to the airway
Which of the following is considered the mode of action for surfactant?
B. to replace missing surfactant
All the following are hazards or complications of exogenous surfactants except:
A. tachycardia
You are in the room of a 26-week gestational baby that has just been born. The newborn wieghs 1200 g. On assessment you find the baby has poor color, substernal retractions, nasal flaring, RR of 45, HR of 140. You note that the baby is difficult to bag. Which of the following agents wyould you recommend?
B. beractant
A significant side effect of corticosteroid use is inhibition of:
B. HPA axis
All of the following are types of corticosteroids produced in the adrenal cortex except:
A. corticotropin-releasing factor
Corticosteroids normally produced by the body are known as:
D. endogenous
Which of the following are examples of steroids available for inhalation?
I. flunisolide
II. azmacort
III. QVAR
IV. interleukin
B. I, II, and III only
The rise and fall of levels of glucocorticoids in the body follows what kind of rhythm?
B. circadian
The inflammatory process includes which of the following activities?
I. mediator cascade
II. incr vasular permeability
III. leukocytic infiltration
IV. phagocytosis
D. I, II, III, and IV
The major cells responsible for an inflammatory response in asthma are:
B. mast cells and eosinophils
The early phase of an astmatic reaction occurs during what time frame?
A. 15 min to an hour
The product combining an inhaled steroid and a bronchodilator is:
B. advair
Side effects of systemic steroid treatment include which of the following?
I. HPA suppression
II. cough
III. dysphonia
IV. psychiatric reactions
C. I and IV only
Side effects of aerosolized steroid use include all of the following except:
D. osteoporosis
In COPD, the primary inflammatory cells are:
C. neutrophils
The steroids responsible for secondary male sex characteristics are known as:
B. androgenic
Corticosteroids are used with asthmastics and COPD patients to achieve which effect?
B. antiinflammatory
Use of oral steroids for long periods of time can cause:
D. HPA suppression
In what dosage form is/are corticosteroids available for use in the US?
D. all of the above
Which of the following is a common side effect of inhaled corticosteroids?
C. oral candidiasis
A patient has been taking oral prednisone for 1 week following a severe episode of asthma. The physician decides to switch the patient to aerosolized beclomethasone (QVAR). What is the best way to accomplish this?
C. begin the aerosol and begin to gradually taper off the oral dose
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
Use of systemic corticosteroids can cause all of the following, except:
A. incr endogenous steroid production
Your patient tells you that she is having chest tightness and wheezing four to six times per week, plus she wakes up with chest tightness and wheezing about once per week. She uses albuterol each time, with relief. She is taking no other medication, except her albuterol MDI. What other medication would you suggest be prescribed for her?
