5C: OLD

Question 1

What does the obstruction of air flow result in?

Answer 1

Impairments of mechanical function (primarily reduce FEV1) and gas exchange

Question 2

According to GOLD, what should the FEV1/FVC ratio be?

Answer 2

> .75

Question 3

What is GOLD Stage 1?

Answer 3

Mild - FEV1 is 80% or greater than predicted

Question 4

What is GOLD Stage 2?

Answer 4

Moderate - FEV1 between 50-80% of predicted

Question 5

What is GOLD Stage 3?

Answer 5

Severe - FEV1 between 30-50% of predicted

Question 6

What is GOLD Stage 4?

Answer 6

Very severe - FEV1 < 30% of predicted

Question 7

What are the two types of COPD?

Answer 7

Emphysema and bronchitis

Question 8

What is a pack year?

Answer 8

pack year = ppd x yrs

Question 9

What does smoking inhibit with Emphysema that leads to destruction of alveolar walls?

Answer 9

Alpha 1-antitrypsin

Question 10

Why are WBC’s released with emphysema COPD and what is the effect?

Answer 10

To try and get rid of smoking vapor particles, but they end up destroying the alveolar walls because of the lack of alpha 1-antitrypsin

Question 11

What is the result of early airways closure with COPD?

Answer 11

Overinflation of the alveoli that causes air to get trapped and ventilation/perfusion mismatch

Question 12

What are permanent effects of COPD?

Answer 12

Enlargement of alveoli, loss of elastic recoil of alveoli, lungs, and thoracic cage

Question 13

What is the result of overinflation of the alveoli?

Answer 13

Increased RV and increased compliance of the lungs and increased resting size

Question 14

What happens to rib orientation over time with COPD?

Answer 14

Barrel chested - Increased A-P diameter, and diaphragm flattens

Question 15

What can happen if hypoxemia persists in a COPD patient?

Answer 15

Pulmonary HTN

Question 16

In advanced cases, what can the change in diaphragm position result in?

Answer 16

Paradoxial breathing

Question 17

What are some common symptoms of COPD?

Answer 17

SOB, DOE, orthopnea, wheezing, decreased breath sounds, increased RR, chronic cough, malaise, weight loss

Question 18

What are observable signs of COPD?

Answer 18

Digital clubbing, peripheral cyanosis, barrel chest, elbow roughness from UE support

Question 19

What happens to accessory muscles with COPD?

Answer 19

Hypertrophy

Question 20

What happens to FEV1 with COPD?

Answer 20

Decreases

Question 21

What is bronchitis?

Answer 21

Productive cough for 3+ more months for at least 2 years

Question 22

Why is there excess mucous secretions with bronchitis?

Answer 22

Hyperplasia at goblet cells and mucous glands

Question 23

What happens at the lungs secondary to decreased ventilation?

Answer 23

Vasoconstriction

Question 24

What can cause a patient with Bronchitis to appear bloated?

Answer 24

Vasoconstriction leads to increased pulmonary pressures and ultimately R sided CHF

Question 25

What are the four key symptoms of bronchitis?

Answer 25

1. Productive cough 2. Bloated 3. Peripheral cyanosis 4. SOB

Question 26

What is CF and the four effects?

Answer 26

Genetic condition that causes 1. Increased mucous production 2. Thick secretions that block airways 3. Chronic inflammation 4. High susceptibility to infection

Question 27

What does hyperinflation with CF result in?

Answer 27

Decreased gas exchange and hypoxemia

Question 28

What are the 5 signs of CF?

Answer 28

1. Hyperinflation on x-ray 2. Increased RR 3. Rales and wheezes 4. Productive cough and thick secretions 5. Decreased endurance

Question 29

What is the definition of Asthma?

Answer 29

Reversible OLD characterized by inflammation and increased reactivity of smooth airway muscles to stimuli

Question 30

What is the response to stimuli with asthma?

Answer 30

Chronic inflammation and then bronchospasm and bronchoconstriction related to the stimuli

Question 31

What are the four types of asthma?

Answer 31

1. Extrinsic 2. Intrinsic 3. Exercise induced 4. Occupational

Question 32

What is extrinsic asthma?

Answer 32

Reaction to allergens

Question 33

What is intrinsic asthma?

Answer 33

Unknown, but triggered by pulmonary infections

Question 34

What is exercise induced asthma?

Answer 34

Related to increased RR demand, airway temp and humidity

Question 35

What is occupational asthma?

Answer 35

Similar to extrinsic, but directly items at place of work

Question 36

What is Bronchiectasis?

Answer 36

Progressive with permanent airway damage that is similar to emphysema

Question 37

What is the specific cause of Bronchiectasis?

Answer 37

Chronic inflammation after pulmonary infection

Question 38

What conditions can then lead to Bronchiectasis?

Answer 38

1. CF - half of all cases 2. RA 3. Sinusitis

Question 39

What is the Stage 1 of Bronchiectasis?

Answer 39

Chronic infection

Question 40

What is Stage 2 of Bronchiectasis?

Answer 40

Chronic inflammatory response to infection

Question 41

What is Stage 3 of Bronchiectasis?

Answer 41

Impaired immune defense and decreased mucociliary ability

Question 42

What is Stage 4 of Bronchiectasis?

Answer 42

Permanent dilation of airways

Question 43

What are 4 signs of Bronchiectasis?

Answer 43

1. Persistent cough with large amounts of sputum 2. Dyspnea 3. Some chest pain 4. Fatigue, weight loss, decreased endurance