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28 PHARMACY PREP COPD 1-A 70-year-old patient with COPD and the doctor doesn’t want to give him any vaccine; his daughter is very worried that that she will get influenza if her father gets it. What will you do? Patient profile: No allergies, currently has fever. a) Vaccinate all family family and health care givers of this person, except the father b) Vaccinate all family including father c) Put him in institution d) Counsel him about compliance of his his treatment treatment e) None of the above Ans: A 2. A 45 year old superintendent have medication condition with emphysema and pain and is not controlled, the doctor switched him to morphine and his daughter came to the pharmacy, you will call the doctor because: Patient medication profile: Combivent (Ipratropium + Salbutamol) Flovent (Fluticasone – a corticosteroid) A. You will ask to change his medication B. To tell the dose of medication because its too much C. To ask for written prescription of morphine D. Recommend to stop Flovent E. Recommend to stop fluticasone Ans-C 3- Patient has COPD and renal failure, developed pneumonia, which of the following fluroquinolones can be used? A-Ciprofloxacin B-Moxifloxacin C-Levofloxacin D-Norfloxacin E-Gemi Ans-B Hepatic elimination antibiotics: doxi, azithro, and clarithro (major), Moxi, clindamycin, Pen V, Ceftriaxone, Spectinomycin Copyright © 2000 to 2010 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited 27-1 and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep
PharmacyPrep.Com 4. a. b. c.
COPD
What can you advice the doctor about patients with emphysema To add Salmeterol - LABA* To add Salbutamol To add Cromolyn sodium
5.In a COPD patient, which parameters you will measure to assess the disease or treatment progress A. A thorough history of the patient including environmental factors, cigarette smoking, occupational exposure B. Physical examination like signs of hyperinflation, airflow obstruction, chronic hypoxemia and pulmonary hypertension C. Laboratory tests like CBC, chest radiography, spirometry before and after bronchodilation, pulse oximetry, arterial blood gases, alpha antiprotease level D. Sputum production, dyspnea, exercise capacity, frequency of exacerbation E. All of the above Ans: E REF. (TC, 4th edition, 431) 6-A 50-year-old male patient with COPD, using Ventolin inhaler, which of the following is need not to discuss with him? A-About inhalers B-About environmental triggers C-About turbohaler D-When to see your doctor E-Avoid Asthma triggers Ans-C 7-A 70-year-old female COPD patient should receive the following vaccination? I-Tetanus vaccine II-Influenza vaccine III-Pneumococcal vaccine a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-D 8. A 70 years old patient uses salbutamol inhaler and Ipratropium inhaler for his COPD. He still has cough and sputum indicating that his COPD is not under control. Next step for his doctor to initiate is: (A) Give antibiotics to treat his infection (B) Add inhaled corticosteroid, antibiotic and replace ipratropium by Tiotropium (C) Add long acting Tiotropium (D) Add theophylline (E) None of the above Copyright © 2000 to 2010 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited 27-2 and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep
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COPD
Answer: (B) TIPS: Antibiotics are used as adjuncts. 9. Patient is 70 years old experiencing COPD that is not under control. His doctor wants to do assessment for his COPD to assess his condition during an exacerbation. Best monitoring parameters to assess his condition is: (A) Respirometer and histamine test challenge (B) Peak flow meter (C) Arterial blood gas determination (D) X-ray to the chest (E) None of the above Answer: (C) TIPS: Arterial blood gas determination is the gold standard to assess oxygenation and ventilation during exacerbation. Reference: Therapeutic Choices 5th edition Page 662
Copyright © 2000 to 2010 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited 27-3 and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep
