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AAPTA PRE-WRITTEN EXAM PRACTICE SERIES FOR APC

Quiz by Krushit Patel

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6 questions
Show answers
  • Q1
    Case 1: 35 year old man with asthma. - wheezy since birth with triggering agents including upper respiratory tract infections, exercise, dog hair, and house dust mites. - admitted to hospital today by his general medical practitioner because of worsening symptoms and difficulty taking his medications. - currently using two metered dose inhalers with a spacer for the delivery of his medications - Salbutamol (Ventolin), a sympathomimetic (B2-agonist) and beclomethasone dipropriate (Becotide) - persistent, non-productive cough, expiratory wheezes and laboured breathing - appears flushed and very anxious and is having difficulty completing sentences. Arterial blood gases on admission • SaO2 = 94 (FiO2 = 0.4) • PaO2 (on O2) = 10 kPa (135mm Hg) • PaCO2 (on O2) = 4.1 kPa (31mmHg) • pH = 7.47 On examination • Heart Rate (HR) = 100beats /min • Temperature = 37.8 oC • Respiratory Rate (RR) = 28 breaths/min (shallow, prolonged expiration; short, gasping inspiration) • FEV1/FVC ratio = 65% • Auscultation – reduced breath sounds throughout the lung fields with widespread expiratory wheeze 1. The patient’s chest X-ray is likely to show evidence of
    an enlarged heart
    hypoinflation
    hyperinflation
    mediastinal shift
    120s
  • Q2
    2. The patient’s FEV1/FVC ratio indicates he has
    severe airway obstruction
    a restrictive airway pattern
    moderate airway obstruction
    an obstructive airway pattern
    120s
  • Q3
    3. What is the rationale for using a spacer for the delivery of Becotide in the patient’s case?
    because four or five puffs of Becotide can be inserted into the spacer for each breath
    to reduce the possibility of oral candidiasis and dystonia
    to increase inertial impaction in the large airways
    because a spacer makes it easier for the person to inhale at a fast inspiratory rate
    120s
  • Q4
    4. Becotide has which of the following actions?
    all of the above are correct
    it decreases microvascular permeability
    it is an anti-inflammatory steroid
    it decreases bronchial hyperreactivity
    120s
  • Q5
    5. Sympathomimetic drugs
    increase myocardial contractility
    may produce bronchospasm and peripheral vasoconstriction in low doses
    all of the above are correct
    bronchodilate the large airways
    120s
  • Q6
    6. Which of the following is true with regard to the patient’s inhaled medications?
    breath holding increases inertial impaction of the particles
    rapid inspiration increases the inertial impaction of the particles
    particles between 5 and 10 ìm are deposited in the small airways
    gravitational sedimentation is time-dependent
    120s

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