Board Review Corner

Adult Asthma, COPD & ABPA

By David A. Khan, M.D.

1. Which of the following is a characteristic of sudden asphyxic asthma?

A. Elevated total serum IgE
B. Increased IL-4 in BAL
C. Coexistent nasal polyp disease
D. Neutrophilic inflammation of the airway mucosa
E. Deposition of fibronectin beneath the basement membrane

2. Which of the following statements is true regarding beta-2 adrenergic receptors in asthma?

A. Gene is located on chromosome 11q13
B. Only 2 polymorphisms exist
C. Gly 16 variant is associated with less beta-2 adrenergic receptor downregulation
D. Glu 27 variant is associated with lower airway reactivity
E. None of the above

3. Which of the following statements is true regarding steroid-insensitive asthma?

A. GRβ levels are decreased
B. Decrease in GCR number most common cause
C. Typically responds to methotrexate
D. Methylprednisolone is more effective than prednisone in majority
E. GCR binding affinity often decreased

4. Which of the following is a minimal essential criteria for allergic bronchopulmonary aspergillosis?

A. Serum precipitating antibodies to A fumigatus
B. Chest roentgenographic infiltrates
C. Total serum IgE concentration > 417 kU/L
D. Peripheral blood eosinophilia
E. Mucus plugs containing A fumigatus

5. Which of the following statements is true regarding the pathophysiology of COPD/emphysema?

A. Most inflammation occurs in the central airways
B. Neutrophils, macrophages and eosinophils are markedly increased in BAL fluid
C. Matrix metalloproteinases-1 and –9 are decreased
D. CD8+ T cells are the predominant T lymphocyte in lung biopsies
E. IL-8 is increased but TNF-alpha is decreased in sputum

Answers:
1. D
2. D
3. E
4. C
5. D