Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory > COPD > Flashcards

COPD Flashcards

1
Q

What is COPD

A

Chronic bronchitis
Emphysema
-productive cough more than 3 months of year for 2 consecutive years-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Does COPD cause clubbing

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the scale used for impact of COPD?

A

MRC Dyspnoea scale
Grade 1 – Breathless on strenuous exercise
Grade 2 – Breathless on walking up hill
Grade 3 – Breathless that slows walking on the flat
Grade 4 – Stop to catch their breath after walking 100 meters on the flat
Grade 5 – Unable to leave the house due to breathlessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does spirometry show?

A

Obstructive
FEV1/FVC ratio of <0.7
Non reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is severity of COPD graded?

3-5-8- fibonacci (add on prev number

A 
With FEV1
Stage 1: FEV1 >80% of predicted
Stage 2: FEV1 50-79% of predicted
Stage 3: FEV1 30-49% of predicted
Stage 4: FEV1 <30% of predicted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What other investigations should be done in COPD?

A

Chest xray to exclude other pathology such as lung cancer.
Full blood count for polycythaemia or anaemia. Polycythaemia (raised haemoglobin) is a response to chronic hypoxia.
Body mass index (BMI) as a baseline to later assess weight loss (e.g. cancer or severe COPD) or weight gain (e.g. steroids).
Sputum culture to assess for chronic infections such as pseudomonas.
ECG and echocardiogram to assess heart function.
CT thorax for alternative diagnoses such as fibrosis, cancer or bronchiectasis.
Serum alpha-1 antitrypsin to look for alpha-1 antitrypsin deficiency. Deficiency leads to early onset and more severe disease.
Transfer factor for carbon monoxide (TLCO) is decreased in COPD. It can give an indication about the severity of the disease and may be increased in other conditions such as asthma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is non medical management of COPD?

A

Stop smoking
Pulmonary rehab training
Pneumococcal and flu vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is medical management of COPD?

A
  1. SABA/SAMA (ipatropium)
  2. If no asthma/steroid responsiveness- LABA and LAMA combination inhaler
  3. If positive asthma or steroid response then LABA and ICS “Fostair”, then stepped up to LABA LABA and ICS triple therapy
    3 If severe nebs/oral theophylline/ carbocysteine/prophylactic azithro/O2 at home
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are indications for home O2?

A

Chronic hypoxia
Polycythaemia
Cyanosis
Heart failure secondary to cor pulmonae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is seen on an ABG for COPD?

A

Acidosis if CO2 retention

Raised bicarb indicated they chronically retain CO2- if still acidotic is acute on chrnoic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is ABG for type 1 resp failure

A

Normal pCO2 with low O2

only 1 affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Raised CO2 and low PO2

A

Type 2

2 affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are issues with home O2?

A

Excessive O2 can depress resp drive slowing breathing and effort and leading to increased CO2 retention. If already retaining CO2 needs careful monitoring with ABGs and O2 sats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What masks are used in COPD O2

A

Venturi so that % controlled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What Sats aimed for in home O2?

A

88-92% if retaining

If not retaining >94%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How are exacerbations treated at home?

A

Pred 7-14 days
Nebs
ABX in infection

In hospital
Neb bronchodilators
Steroids (hydrocortisone/pred
ABX
Physio to clear sputum
BIPAP
Severe:
IVE aminophylline
NIV
Intubate
17
Q

What is cor pulmonae?

A

Fluid overload due to heart failure, oedema and RVH

18
Q

What does alpha 1 antitrypsin deficiency cause?

A

Early onset

Worse prog

19
Q

What does disease process of COPD include?

A
  • Submucosal bronchial gland enlargement
  • Goblet cell metaplasia
  • Mucous hypersecretion
  • Epithelial squamous metaplasia
  • Ciliary dysfunction
  • Hypertrophy of smooth muscle and connective tissue
  • Progressive capillary bed obliteration
20
Q

What are signs of CO2 retention?

A

Flap

Confusion

21
Q

What are the 2 classic presentations of COPD?

A

Pink puffer- CO@ sensitive

Blue Bloated- hypoxia due to depressed resp drive, Cor pulmonae- CO2 resistant

22
Q

What is spirometry explanation

A

Overall high tidal and residual volumes.

The expiratory limb of the flow volume loop is ‘scooped’ as mid expiratory flow is compromised as airways collapse

23
Q

WHat are bacterial causes of exacerbations?

A

H influenzae
S. pneumonia
Moraxella catarrhalis

24
Q

Which ABX used in exacerbation:

A

Amox
Doxy if allergic to pen
Co Amox if not responding

25
Q

What organisms in bronchiecstasis

A

H influenza
S pneumoniae
S aureus
P aeruginosa

26
Q

How do you manage bronchiecstasis

A 
Chest physio
Mucolytics
Hypertonic saline nebs
Macrolides
Frequent cultures

Respiratory (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions