adult obstructive lung disease Flashcards
(22 cards)
what is the most common chronic disease in 1st world countries?
asthma
who has the worst outcome for asthma?
young af am males
pathogenesis of asthma
inflammation + cellular inffiltration
major inflammatory mediators of asthma
histamine, leukotrienes, kallikrein, platelet activation factor
positive bronchodilator test for asthma: Requires > ____% increase in FEV1 as well as at least a ____ ml increase or increases in the FVC or FEF25-75
Requires > 12% increase in FEV1 as well as at least a 200 ml increase or increases in the FVC or FEF25-75
how to use long acting beta agonists in tx of asthma?
NEVER as monotx
which drug used to tx asthma has a small therapeutic window?
theophylline
does asthma or COPD involve airflow limitation that is reversible?
asthma
cough occurs every day with sputum production that lasts for at least 3 months, 2 years in a row
chronic bronchitis
what results in airway limitation in COPD (2) ?
- small airway disease
2. parenchymal disease
Abnormal and permanent enlargement of the airspaces distal to the terminal bronchioles and accompanied by destruction of the airspace walls.
emphysema
FEV1/FVC less than 0.7 indicates?
obstructive lung disease
what do you use to determine severity of COPD?
post bronchodilator FEV1
what % post bronchodilator FEV1 dictates severe COPD
under 50%
how to assess risk of exacerbtations of COPD?
- h/o exacerbations 2. spirometry
high risk of COPD exacerbations: ____exacerbations within last year or an FEV ______
2+ exacerbations within last year or an FEV under 50%
continuous inflammation of airway, chronic productive cough typically w/ large amts of sputum
bronchiectasis
what is the single most important intervention to prevent COPD and slow progression of disease?
tobacco smoking cessation
what medications cure COPD?
NONE, but can modify long term decline in lung fxn
which vaccinations should a person w/ COPD be provided?
influenza, pneumococcal
in management of COPD exacerbations, who should be tx’d with antibiotics?
those with the 3 cardinal sx or who require mechanical ventilation
what are the 3 cardinal sx that dictate antibiotic usage in management of COPD exacerbations
increased dyspnea, increased sputum volume, and increased sputum purulence
