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Clinical Skills

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

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  1. Clinical Skills Formative Quiz Clinical Skills and Simulation Team Respiratory Disease Quiz – Peak Flow

  2. Question 1 Question 1 Asthma can confidently be diagnosed using a single PEFR reading TRUE FALSE

  3. Question 2 Question 2 What is most likely to have happened at Point A Patient Started Asthma Medication Patient Stopped Asthma Medication A

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. Question 10 Question 10 Whilst performing a PEFR the patient should be instructed to take a deep breath in through their: Mouth Nose

  12. ANSWERS

  13. Question 1 Question 1 Asthma can confidently be diagnosed using a single PEFR reading TRUE FALSE

  14. 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

  15. Question 2 Question 2 What is most likely to have happened at Point A Patient Started Asthma Medication Patient Stopped Asthma Medication A

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  21. 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

  22. 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

  23. 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

  24. 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

  25. 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

  26. 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

  27. 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

  28. 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

  29. 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

  30. 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.

  31. Question 10 Question 10 Whilst performing a PEFR the patient should be instructed to take a deep breath in through their: Mouth Nose

  32. 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

  33. WELL DONE Please add up your marks… Score is out of 10

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