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Clinical Skills. Formative Quiz. Clinical Skills and Simulation Team. Respiratory Disease Quiz – Peak Flow. Question 1. Question 1. Asthma can confidently be diagnosed using a single PEFR reading. TRUE. FALSE. Question 2. Question 2. What is most likely to have happened at Point A

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Clinical skills

Clinical Skills

Formative Quiz

Clinical Skills and Simulation Team

Respiratory Disease Quiz – Peak Flow


Question 1

Question 1

Question 1

Asthma can confidently be diagnosed using a single PEFR reading

TRUE

FALSE


Question 2

Question 2

Question 2

What is most likely to have happened at Point A

Patient Started Asthma Medication

Patient Stopped Asthma Medication

A


Question 3

Question 3

Question 3

Which of the following is correct regarding parameters that effect PEFR?

Sex, Age, Weight

Sex, Age, Height

23 Today

55 Today

64 Today


Question 4

Question 4

Question 4

What is the most useful test procedure for establishing the diagnosis and severity of COPD?

PEAK EXPIRATORY FLOW RATE

SPIROMETRY

A

B


Question 5

Question 5

After a patient does 3 readings on a PEFR meter the reading that is recorded on the PEFR graph is:

The Third Reading

The Highest Reading

Question 5


Question 6

Question 6

In the patients Asthma Action Plan home monitoring of asthma using daily PEFR’s would best be correlated with:

The patient’s best ever PEFR

The estimated best value for the patient’s given age, sex and height

Question 6


Question 7

Question 7

Christopher, a 45 year old, male, smoker, 1.8m tall, who has noticed increased shortness of breath on exertion in recent months.

From the PEFR diary the most likely diagnosis is:

Asthma

COPD

Case Study 1


Question 8

Question 8

Kimberly, a 22 year old, female smoker, 1.9m tall, who has noticed a persistent nocturnal cough in recent months.

From the PEFR diary the most likely diagnosis is:

Asthma

COPD

Case Study 2


Question 9

Question 9

Kimberly is diagnosed with asthma which is through to have been triggered by a kitten that she was given for her birthday. Over the next fortnight her PEFR diary is a below. What is most likely to have happened at point B on the graph

She gave the kitten away to a friend

She commenced inhaled corticosteroids

Case Study 2 - Continued


Question 10

Question 10

Question 10

Whilst performing a PEFR the patient should be instructed to take a deep breath in through their:

Mouth

Nose


Clinical skills

ANSWERS


Question 11

Question 1

Question 1

Asthma can confidently be diagnosed using a single PEFR reading

TRUE

FALSE


Answer 1

Answer 1

Answer 1

Asthma can confidently be diagnosed using a single PEFR reading

A single PEFR reading may show evidence of airway obstruction if it is below the predicted value, however the cause of the airflow obstruction would not be clear (e.g. COPD or Asthma).

A peak expiratory flow diary demonstrating diurnal variability of >30% would be highly suggestive of asthma, however spirometry is now the gold standard for diagnosis.

FALSE


Question 21

Question 2

Question 2

What is most likely to have happened at Point A

Patient Started Asthma Medication

Patient Stopped Asthma Medication

A


Answer 2

Answer 2

Answer 2

What is most likely to have happened at Point A

B

Patient Stopped Asthma Medication

The diurnal variation increases in amplitude and the general mean PEFR drops indicating poorer control

A


Question 31

Question 3

Question 3

Which of the following is correct regarding parameters that effect PEFR?

Sex, Age, Weight

Sex, Age, Height

23 Today

55 Today

64 Today


Answer 3

Answer 3

Answer 3

Which of the following is correct regarding parameters that effect PEFR?

Weight is not a parameter that effects PEFR

B

Sex, Age and Height

23 Today

55 Today

64 Today


Question 41

Question 4

Question 4

What is the most useful test procedure for establishing the diagnosis and severity of COPD?

PEAK EXPIRATORY FLOW RATE

SPIROMETRY

A

B


Answer 4

Answer 4

Answer 4

What is the most useful test procedure for establishing the diagnosis and severity of COPD?

Spirometry measures FEV1 and FEV/FVC% and is the recommended Gold Standard for diagnosis and measurements of severity in COPD

SPIROMETRY

B


Question 51

Question 5

After a patient does 3 readings on a PEFR meter the reading that is recorded on the PEFR graph is:

The Third Reading

The Highest Reading

Question 5


Answer 5

Answer 5

Answer 5

After a patient does 3 readings on a PEFR meter the reading that is recorded on the PEFR graph is:

B

The Highest Reading


Question 61

Question 6

In the patients Asthma Action Plan home monitoring of asthma using daily PEFR’s would best be correlated with:

The patient’s best ever PEFR

The estimated best value for the patient’s given age, sex and height

Question 6


Answer 6

Answer 6

Answer 6

In the patients asthma action plan home monitoring of asthma using daily PEFR’s would best be correlated with:

A

The Patients Best Ever PEFR


Question 71

Question 7

Christopher, a 45 year old, male, smoker, 1.8m tall, who has noticed increased shortness of breath on exertion in recent months.

From the PEFR diary the most likely diagnosis is:

Asthma

COPD

Case Study 1


Answer 7

Answer 7

Case Study 1

Christopher, a 45 year old, male, smoker, 1.8m tall, who has noticed increased shortness of breath on exertion in recent months. From the PEFR diary the most likely diagnosis is:

B

COPD

General Baseline is lower than expected for his sex and height with little diurnal variation


Question 81

Question 8

Kimberly, a 22 year old, female smoker, 1.9m tall, who has noticed a persistent nocturnal cough in recent months.

From the PEFR diary the most likely diagnosis is:

Asthma

COPD

Case Study 2


Answer 8

Answer 8

Case Study 2

Kimberly, a 22 year old, female smoker, 1.9m tall, who has noticed a persistent nocturnal cough in recent months.

A

Asthma

Asthma, note high amplitude diurnal variation with ‘morning dipping’ typical of poorly controlled asthma


Question 91

Question 9

Kimberly is diagnosed with asthma which is through to have been triggered by a kitten that she was given for her birthday. Over the next fortnight her PEFR diary is a below. What is most likely to have happened at point B on the graph

She gave the kitten away to a friend

She commenced inhaled corticosteroids

Case Study 2 - Continued


Answer 9

Answer 9

Case Study 2 - Continued

Kimberly is diagnosed with asthma which is through to have been triggered by a kitten that she was given for her birthday. Over the next fortnight her PEFR diary is a below. What is most likely to have happened at point B on the graph

B

She commenced inhaled corticosteroids

This explains the relatively rapid control of her symptoms as demonstrated by reduced amplitude of diurnal variation and increased average PEFR reading.

Cat dander and saliva extract can remain in even the cleanest of homes for over a year in levels enough to provoke asthma in susceptible individuals.


Question 101

Question 10

Question 10

Whilst performing a PEFR the patient should be instructed to take a deep breath in through their:

Mouth

Nose


Answer 10

Answer 10

Answer 10

Whilst performing a PEFR the patient should be instructed to take a deep breath in through their:

X

Nose

Mouth

Inspiration through the nose increases the ‘dead space’ in the respiratory system and hence reduces the vital capacity


Clinical skills

WELL DONE

Please add up your marks…

Score is out of 10


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