42. COPD Flashcards
COPD is most commonly caused by ___ =, but can be caused by other air pollutants
tobacco smoke
____ is the destruction of the small passages in the lungs (alveoli)
Emphysema
____ is the inflammation and narrowing of the bronchial tubes (results in mucus production and chronic cough)
Bronchitis
Pts with ____ deficiency are at a higher risk of developing COPD
Alpha-1 antitrypsin (AAT)
Note: AAT helps protect lungs from damage caused by inflammation
T/F: In COPD, the limitation of airflow is fully reversible with treatment
False - not fully reversible and progresses over time, leading to gradual loss of lung function
A post-bronchodilator FEV1/FBC < ____ confirms a dx of COPD
0.70
Which guidelines are used for COPD treatment?
GOLD
Predicted FEV1 for GOLD 1 (Mild) COPD
FEV1 ≥ 80%
Predicted FEV1 for GOLD 2 (Moderate) COPD
50% ≤ FEV1 ≤ 79%
Predicted FEV1 for GOLD 3 (Severe) COPD
30% ≤ FEV1 ≤ 49%
Predicted FEV1 for GOLD 4 (Very Severe) COPD
FEV1 < 30%
What are the two most commonly used symptom assessment scoring systems?
Modified British Medical Research Council (mMRC) dyspnea scale
COPD Assessment Test (CAT)
mMRC dyspnea scale assesses _____ whereas the CAT assesses ___
breathlessness (on scale from 0-4)
range of symptoms (e.g. cough, mucus, production, chest tightness, energy level, breathlessness, sleep patterns, limitations to normal activity; on scale from 0-40)
Define COPD exacerbation
Increase in respiratory symptoms that worsen over < 14 days
Hospitalization for COPD exacerbation is a/w increased risk of ___
death
If a patient has __ or more exacerbations per year, they are considered to be frequent exacerbators
2 or more
Define COPD group A:
CAT score ___
mMRC score ____
Exacerbations ____
CAT <10
mMRC 0-1
0-1 moderate exacerbations (no hospitalization)
Define COPD group B:
CAT score ___
mMRC score ____
Exacerbations ___
CAT ≥10
mMRC ≥ 2
0-1 moderate exacerbations (no hospitalization)
Define COPD group E:
CAT score ___
mMRC score ____
Exacerbations ___
≥ 2 moderate exacerbations or ≥ 1 hospitalization d/t exacerbations
regardless of CAT/mMRC scores
Vaccine recommendation for COPD pts
Annual influenza, pneumococcal vaccines and Tdap
___ is the only non-drug management strategy proven to slow progression of COPD
Smoking cessation
____ are first-line treatment for all COPD pts
Bronchodilators
ICS are recommended in select pts with hx of exacerbations and eosinophil counts (marker of inflammation) ≥ _____ cells/µL
≥300
Note: not recommended in pts with lower eosinophil counts (<100), no demonstrated benefit
Initial pharmacologic therapy for COPD: Group A
Bronchodilator (SAMA prn, SABA prn, LAMA or LABA)
