1. The two major diseases causing obstruction of airways in the lung are:

• a. COPD and cor pulmonale.
• b. COPD and asthma.
• c. Asthma and cor pulmonale.
• d. Asthma and congestive heart failure.

2. Emphysema is:

• a. A form of COPD.
• b. Characterized by chronic cough and excess sputum production.
• c. Reversible.
• d. Typically a disease of people under 40 years of age.

3. Chronic bronchitis is:

• a. Always a form of COPD.
• b. Characterized by chronic cough and excess sputum production.
• c. Characterized by large, useless air spaces in the lung.
• d. Another name for asthma.

4. The common feature of all forms of COPD is:

• a. Emphysema.
• b. Chronic bronchitis.
• c. Asthma.
• d. Chronic, irreversible airflow obstruction.

5. COPD is most common in:

• a. Children.
• b. Teenagers.
• c. Adults ages 19 to 55 years old.
• d. Adults older than 55 years.

6. A "pack-year" is the equivalent of having smoked one pack of cigarettes:

• a. Each month for a year.
• b. Each week for a year.
• c. Each day for a year.
• d. Per year.

7. In normal lungs:

• a. No air is left inside after a person exhales.
• b. Some air is left inside after a person exhales.
• c. Secretions come only from saliva and postnasal drip.
• d. The airways are dry unless the person has an illness.

8. In their normal state in the body, lungs are heavy because:

• a. They contain numerous blood vessels filled with blood.
• b. The main airways are made of thick cartilage.
• c. The airways always contain significant amounts of mucus.
• d. Each of the millions of alveoli is coated with elastin and collagen.

9. Asthma:

• a. Is the cause of COPD.
• b. Is the same as COPD.
• c. Makes a smoker more likely to develop COPD.
• d. Seems to protect a person from developing COPD.

10. Alpha1-antitrypsin (AAT) deficiency:

• a. Is a common genetic defect that affects 1 in 10 people.
• b. Makes a person especially prone to developing COPD.
• c. Protects people from developing COPD.
• d. Is a genetic disease caused by COPD.

11. Proteases are:

• a. Destructive enzymes secreted into the lung tissue during COPD.
• b. The building blocks of proteins.
• c. Drugs used to treat COPD.
• d. Proteins used to construct extracellular matrices.

12. In COPD, airway obstruction is:

• a. In part, the result of thickening and stiffening of the walls of small airways.
• b. In part, the result of thinning the walls and expanding the inner dimensions of small airways.
• c. Usually a sign of a respiratory infection or asthma.
• d. Uncommon.

13. Hyperinflation of the lungs:

• a. Means the patient can breathe more air and is a sign that COPD is improving.
• b. Is a technique taught to COPD patients to rest their abdominal breathing muscles.
• c. Is an athlete's trick of packing more air into small lungs.
• d. Means that after exhaling there is more than a normal amount of air left in the lungs.

14. Pulmonary hypertension:

• a. Means that the airways in the lung pose a larger-than-normal resistance to air flow.
• b. Means that the arteries in the lung pose a larger-than-normal resistance to blood flow.
• c. Is a common cause of COPD.
• d. Is a common cause of coronary artery disease (CAD).

15. The main debilitating symptom of COPD is:

• a. Weight loss.
• b. Dyspnea.
• c. Cough.
• d. Weight gain.

16. In the medical history of people with COPD, the most common feature is:

• a. Bouts of clinical depression.
• b. Seasonal allergies.
• c. Many years of cigarette smoking.
• d. Symptoms of reflux disease.

17. People with obstructive lung problems tend to:

• a. Breath through their nose.
• b. Stand when they need to rest.
• c. Sit straight and rigid.
• d. Sit in a tripod position.

18. PaO₂ is the symbol for:

• a. Partial oxygen, meaning oxygen supplementation is rarely needed.
• b. Percent of hemoglobin saturated with oxygen.
• c. Potassium oxide.
• d. The amount of oxygen being carried in the blood.

19. A pulse oximetry value of 80%:

• a. Signifies severe hypoxemia.
• b. Is equivalent to a comfortable PaO₂ of about 80 mm hg (the low range of normal).
• c. Is equivalent to a PaO₂ of almost 100 mm hg (the high range of normal).
• d. Cannot be evaluated without blood labs.

20. Alpha1-antitrypsin deficiency is the most common cause of COPD.

• a. True
• b. False

21. The forced vital capacity (FVC) is the:

• a. Rate at which air can be forcefully expelled from the lungs.
• b. Force with which all the air can be expelled from the lungs.
• c. Amount of air that can be forcefully expelled from the lungs.
• d. Amount of air that can be forcefully expelled from the lungs in 1 second.

22. The percent of the vital capacity that can be exhaled in one second (FEV1/FVC):

• a. Goes up when a person has COPD.
• b. Goes up as a person ages.
• c. Goes down when a person has COPD.
• d. Goes down as a person ages.

23. As COPD worsens, a patient's FEV1:

• a. Continues to increase.
• b. Stops increasing.
• c. Remains unchanged.
• d. Continues to decrease.

24. Acute exacerbations of COPD are:

• a. Almost always caused by respiratory infections.
• b. Usually signaled by nausea and vomiting.
• c. Rare, typically occurring only once in the patient's lifetime.
• d. Caused by a variety of problems and cannot always be explained.

25. COPD patients are encouraged to:

• a. Finish tasks quickly so that they can rest.
• b. Use spray deodorants instead of roll-ons.
• c. Stay indoors on polluted days.
• d. Avoid showering or bathing in the evening.

26. Nicotine replacement therapy:

• a. Is a public relations scam by the drug industry.
• b. Replaces an addiction to cigarettes with an addiction to pure nicotine.
• c. Is aimed at easing withdrawal symptoms of people who have quit smoking.
• d. Is a life-long commitment to taking one of the replacement products.

27. Pulmonary rehabilitation therapy is:

• a. A surgical procedure to remove nonfunctional parts of the lung.
• b. A comprehensive program of exercise and education.
• c. A medical procedure of lung lavage.
• d. An oxygen supplementation program.

28. Parasympathetic bronchodilators such as ipratropium (Atrovent):

• a. Block the effects of acetylcholine, which is an airway constrictor.
• b. Block the effects of norepinephrine, which is an airway relaxer.
• c. Are beta-blockers.
• d. Are beta2 agonists.

29. Some sympathetic bronchodilator medications:

• a. Block the effects of acetylcholine, which is an airway constrictor.
• b. Block the effects of norepinephrine, which is an airway relaxer.
• c. Are beta-blockers.
• d. Are beta2 adrenergic agonists.

30. Epinephrine is:

• a. Selective, acting on only beta1 adrenergic receptors.
• b. Nonselective, acting on all sympathetic receptors.
• c. Selective, acting on only beta2 adrenergic receptors.
• d. Nonselective, acting on only parasympathetic receptors.

31. Albuterol is:

• a. A short-acting beta2 agonist.
• b. A corticosteroid used mainly as an inhaler.
• c. A drug with the same action as epinephrine.
• d. An old drug no longer used for COPD.

32. Theophylline is a:

• a. Parasympathetic anticholinergic drug similar to Atrovent.
• b. Beta-blocker similar to propranolol.
• c. Cholinergic agonist similar to acetylcholine.
• d. Phosphodiesterase inhibitor similar to caffeine.

33. Inhaled corticosteroids:

• a. Have too many serious side effects to be used for COPD.
• b. Are sometimes very helpful for people with COPD.
• c. Are first-choice bronchodilators for treating COPD.
• d. Should not be combined with beta2 agonists for treating COPD.

34. Surgical procedures for COPD:

• a. Are still risky for a large proportion of patients.
• b. Involve insertion of artificial lobes.
• c. Are done to expand the bullae.
• d. Are best done early in the disease process.

35. COPD patients who have an acute exacerbation:

• a. May take a week or more to recover.
• b. Bounce back quickly after rescue treatment with corticosteroids.
• c. Are unlikely to recover.
• d. Should always be treated in an intensive-care unit.