ASTHMA AND COPD

COPDPathophysiology

100

Which of the following is the main risk factor for developing COPD?

A. Viral infections
B. Cigarette smoking
C. High altitude
D. Obesity
E. Air conditioning exposure

B
Smoking is the major risk factor for COPD due to chronic airway inflammation and lung tissue damage.

200

A 65-year-old man with a 45-pack-year smoking history presents with progressive dyspnoea and weight loss. CT imaging shows hyperinflated lungs with decreased vascular markings. Destruction of which structure is primarily responsible for the patient's airflow limitation?

A. Bronchial cartilage
B. Alveolar septa
C. Pulmonary capillary endothelium
D. Type II pneumocytes
E. Pleural mesothelium

B

Destruction of alveolar septa in emphysema leads to: loss of elastic recoil, airway collapse during expiration, airflow obstruction.

COPDPharmacology

100

Which medication is a long-acting muscarinic antagonist (LAMA) used in COPD?

A. Tiotropium
B. Salbutamol
C. Prednisolone
D. Amoxicillin
E. Montelukast

A

Tiotropium blocks muscarinic receptors in bronchial smooth muscle → bronchodilation.

200

What is the mechanism of action of ipratropium?

A. Beta-2 receptor stimulation
B. Inhibits leukotriene receptors
C. Blocks muscarinic receptors in bronchial smooth muscle
D. Stimulates surfactant production
E. Blocks histamine receptors

C

Ipratropium (SAMA) causes bronchodilation by blocking M3 muscarinic receptors.

Random

100

What is the key pathological feature of emphysema?

A. Thickening of pleura
B. Enlargement of airspaces distal to terminal bronchioles
C. Bronchial tumour formation
D. Pulmonary edema
E. Bronchial calcification

B

Emphysema causes destruction of alveolar walls and enlarged airspaces.

200

Which spirometry finding confirms airflow obstruction in COPD?

A. FEV1/FVC > 0.9
B. Normal spirometry
C. Increased FVC
D. Increased TLC only
E. FEV1/FVC < 0.7Normal spirometry

E

COPD is diagnosed when FEV1/FVC ratio < 0.7 after bronchodilator.

300

A COPD patient presents with:

Peripheral oedema

Jugular venous distension

Dyspnoea on exertion

What is the most likely complication?

A. Left heart failure
B. Cor pulmonale
C. Pneumothorax
D. Pulmonary embolism
E. Mitral stenosis

B

Chronic hypoxia in COPD causes vasoconstriction in pulmonary arteries.
This leads to increased pulmonary vascular resistance.
Over time this produces pulmonary hypertension.
The right ventricle has to pump against this high pressure, leading to right ventricular hypertrophy and eventual failure.