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NR 601 Midterm exams with correct ANSWERS
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NR 601 Midterm exams with correct ANSWERS
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NR601 MIDTERM EXAMS COMPLETESOLUTIONS
What yare ythe y3 yprimary yphysiological ychanges yof yaging? y- y✔✔1. yReduced
yphysiological yreserve yof ymost ybody ysystems, yesp. ycardiac, yresp, yrenal.
2. yReduced yhomeostatic ymechanisms ythat yfail yto yadjust yregulatory ysystems y(i.e.
ytemp ycontrol, yfluid/lyte ybalance, yetc.).
3. yImpaired yimmunological yfunction y(infection yrisk yis ygreater, yautoimmune ydz's
ymore yprevalent)
What yis ythe ypreferred yamount yof yexercise yfor yelderly? y- y✔✔30min/day y5 ydays/wk
yof ymoderate yexercise.
If ytrying yto ylose ywt: y60min/day.
What yare yPFTs? y- y✔✔Group yof ytests ythat yprovide yquantifiable ymeasurement yof
ylung yfunction, yused yto ydx yresp yabnormalities yor yassess yprogression/resolution yof
ylung ydz.
What yis yFEV1? y- y✔✔Forced yExpiratory yVolume yin y1 ysecond y(80-120%)
What yis yFVC? y- y✔✔Forced yVital yCapacity y(80-120%)
What yis ynormal yFEV1/FVC yratio? y- y✔✔<0.7 y(70%)
What yis yGOLD y1 ycriteria? y- y✔✔Mild
FEV1 y>/= y80% ypredicted
What yis yGOLD y2 ycriteria? y- y✔✔Moderate
FEV1 y50-79% ypredicted
What yis yGOLD y3 ycriteria? y- y✔✔Severe
FEV1 y30-49% ypredicted
What yis yGOLD y4 ycriteria? y- y✔✔Very ysevere
FEV1 y<30% ypredicted
What yare ythe ysignal ysymptoms yof yCOPD? y- y✔✔Dyspnea
Chronic ycough yw/sputum
,Decreased yactivity ytolerance
Wheezing
What yare ycharacteristics yof yCOPD? y- y✔✔Common, ypreventable, ytreatable.
Characterized yby ypersistent yairflow ylimitation.
Usually yprogressive, yassociated ywith yenhanced ychronic yinflammatory yresponse yin
yairways yand ylungs yto ynoxious yparticles/gases
Airway yfibrosis, yluminal yplugs, yairway yinflammation, yincreased yairway yresistance,
ysmall yairway ydz.
Decreased yelastic yrecoil yof yalveoli.
What yare yrisk yfactors yfor yCOPD? y- y✔✔Smoking y(increasing yw/number yof ypack
yyears)
Second yhand ysmoke
Environmental ypollution y(endotoxins, ycoal ydust, ymineral ydust)
What yis yseen yon yphys yexam yin yCOPD? y- y✔✔May ybe ynormal yin yearly ystates
As yseverity yprogresses: ylung yhyperinflation, ydecreased ybreath ysounds, ywheezes yat
ybases, ydistant yheart ytones y(b/c yof yhyperinflation, yso yS1/S2 ysounds yoff yin
ydistance), yaccessory ymuscle yuse, ypursed ylip ybreathing, yincreased yexpiratory
yphase, yneck yvein ydistention.
How yis yCOPD ydiagnosed? y- y✔✔Spirometry yis ygold ystandard y(pre yand ypost
ybronchodilator).
Irreversible yairflow ylimitation yis yhallmark.
How yis yCOPD ytreated? y- y✔✔Bronchodilators: ybeta yagonists y(long/short),
yanticholinergics y(long/short), yor ycombo.
What yis ythe yMOA yof ybeta yagonists? y- y✔✔Stimulates ybeta-2-adrenergic yreceptors,
yincreasing ycyclic yAMP, yresulting yin yrelaxing yairways.
What yis ythe yMOA yof yanticholinergics? y- y✔✔Block ythe yeffect yof yacetylcholine yon
ymuscarinic ytype y3 yreceptors, yresulting yin ybronchodilation.
Why yare ylong-acting ybeta yagonists yprescribed yfor yCOPD? y- y✔✔They yare yfor
ymoderate yairflow ylimitation.
They yrelieve ysymptoms, yincrease yexercise ytolerance, yreduce ynumber yof
yexacerbations, yimprove yQOL.
, What yare ysome ynon ypulmonary ydiagnoses ythat yresult yin yCOPD-type ysymptoms? y-
y✔✔CHF
Hyperventilation ysyndrome
Panic yattacks
Vocal ycord ydysfunction
Obstructive ysleep yapnea
Aspergillosis
Chronic yfatigue ysyndrome
What yare ysignal ysymptoms yof yasthma? y- y✔✔Wheezing
Shortness yof ybreath
Cough y(esp yat ynight)
Chest ytightness
What yis ychronic ybronchitis? y- y✔✔Daily ychronic ycough yw/increased ysputum yfor yat
yleast y3 yconsecutive ymonths yin yat yleast y2 yconsecutive yyears.
Usually yworse yon ywakening.
May yor ymay ynot ybe yassociated ywith yCOPD.
What yis yemphysema? y- y✔✔Characterized yby yobstruction yto yairflow ycaused yby
yabnormal yairspace yenlargement ydistal yto yterminal ybronchioles.
Chronic yinflammation/remodeling, ytrapping yair, yhindering yeffective yO2/CO2
yexchange y(all ydue yto yinflammatory ymediators yinfiltrating yairways).
What yare ysignal ysymptoms yof yischemic yheart ydz? y- y✔✔Chest ypain
Chest ytightness
Chest ydiscomfort
What yis yischemic yheart ydz? y- y✔✔Imbalance ybetween ysupply yand ydemand yfor
yblood yflow yto ymyocardium
What yare ysignal ysymptoms yof ylung yCA? y- y✔✔Cough
Dyspnea
Wt yloss
Anorexia
Hemoptysis
What yis ylung yCA? y- y✔✔Malignant yneoplasm yoriginating yin yparenchyma yof
ylung/airways
What yare ysignal ysymptoms yof yMI? y- y✔✔Prolonged yCP y(>20min yduration)
SOB
Confusion
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