Asthma and COPD

Question 1

In childhood, what sex is affected more often by Asthma?

Answer 1

Boys

Question 2

In young adulthood, what sex is affected more often by Asthma?

Answer 2

Women

Question 3

What sex achieves remission from Asthma more often?

Answer 3

Males

Question 4

What is a predominant pre-natal risk factor for Asthma?

Answer 4

Prematurity

Question 5

Besides prematurity, what are some other pre-natal risk factors for Asthma?

Answer 5

Ethnicity
Socioeconomic status
C-section
Maternal tobacco use

Question 6

What are some post-natal risk factors for Asthma?

Answer 6

Toxins/allergens in the home, air pollution

Infections, medication use and obesity

Question 7

What is the best studied prevention of Asthma?

Answer 7

Breast feeding

Question 8

Describe the pathophysiology of the airway inflammation with Asthma?

Answer 8

T2 type inflammation with eosinophils, mast cells, etc.

– Defective Resolution process!!

Question 9

Describe the pathophysiology of the airway remodeling with Asthma?

Answer 9

• Increased smooth muscle, mucus glands and production

- Thickened subepithelial reticular lamina

Question 10

What are the symptoms of Asthma?

Answer 10

Cough, recurrent wheezing, dyspnea, chest tightness

Question 11

What are the symptoms of Asthma?

Answer 11

Cough, dyspnea, recurrent wheezing, chest tightness

Question 12

What are some things that can make Asthma worse?

Answer 12

Exercise, night time, weather and allergen exposure changes, laughing/crying/stress

Question 13

Diagnosis of Asthma can be difficult. What 3 things need to be present?

Answer 13

1. Appropriate symptoms
2. Reversible airflow limitation
3. Airway hyper-responsiveness

Question 14

What are the spirometry results with Asthma?

Answer 14

• FEV1 < 80% predicted
• Age adjusted FEV1/FVC < 75%
• Reversibility of obstruction
  = > 12% increase in FEV1 and > 200 ml volume

Question 15

What are the spirometry results with Asthma?

Answer 15

• FEV1 < 80% predicted
• Age adjusted FEV1/FVC < 75%
• Reversibility of obstruction
  = > 12% increase in FEV1 and > 200 ml volume

Question 16

Does normal spirometry exclude Asthma?

Answer 16

NO

Question 17

Intermittent Asthma and Treatment

Answer 17

Symptoms less than 2 days/week

= SABA as needed

Question 18

Asthma symptoms greater than 2days/week but not daily

Answer 18

Mild Asthma

Question 19

Daily Asthma symptoms with some activity limitations

Answer 19

Moderate Asthma

Question 20

Asthma symptoms throughout the day with severe limitations on activities

Answer 20

Severe Asthma

Question 21

What is the treatment for Mild, Moderate and Severe persistent Asthma?

Answer 21

ICS +/- LABA/LAMA

Question 22

What is the treatment for Mild, Moderate and Severe persistent Asthma?

Answer 22

ICS +/- LABA/LAMA

Question 23

What does the use of a SABA > 2 days/week for relief of asthma suggest?

Answer 23

Inadequate control of asthma and need to step up treatment

Question 24

What are some complications of Asthma?

Answer 24

Poor quality of life, exacerbation of symptoms

- Pneumonia, Pneumothorax, respiratory failure, airway remodeling

Question 25

With COPD there is ____ airflow limitation that is ____

Answer 25

Persistent airflow limitation that is irreversible

Question 26

The mortality with COPD is associated with?

Answer 26

Poverty | Increasing male age

Question 27

What are the main risk factors for COPD?

Answer 27

Smoking History of Tuberculosis -- Genetics plays a role

Question 28

Persistent airflow limitation that is irreversible

Answer 28

COPD

Question 29

Common names for the presentations of COPD?

Answer 29

Blue bloaters | Pink Puffers

Question 30

What are the main symptoms of COPD?

Answer 30

Dyspnea Cough with sputum production Recurrent respiratory tract infections

Question 31

What are the spirometry results of COPD?

Answer 31

- FEV1 < 80% predicted - FEV1/FVC < 0.7 - < 12% reversibility

Question 32

What are the spirometry results with COPD?

Answer 32

- FEV1 < 80% predicted - FEV1/FVC < 0.7 - < 12% reversibility

Question 33

Gold 1/mild COPD

Answer 33

FEV1 > 80%

Question 34

Gold2/Moderate COPD

Answer 34

FEV1 between 50-80%

Question 35

Gold3/Severe COPD

Answer 35

FEV1 between 30-50%

Question 36

Gold4/Very severe COPD

Answer 36

FEV1 < 30%

Question 37

Non-pharmacologic treatments for COPD?

Answer 37

- Pulmonary rehab | - Lung volume reduction and transplant

Question 38

Mainstay for pharmacologic treatment for COPD?

Answer 38

Long acting Bronchodilators

Question 39

Mainstay for pharmacologic treatment for COPD?

Answer 39

Long acting Bronchodilators -- LABA/LAMA

Question 40

What is the pharmacologic treatment for those patients that are at high risk of COPD exacerbations?

Answer 40

Inhaled Corticosteroids

Question 41

Why are Inhaled Corticosteroids only given for those COPD patients that are at risk for exacerbation?

Answer 41

The benefit/risk ratio is poor so not recommended for all

Question 42

Inhaled Corticosteroids increase lung function but also the patient's risk for?

Answer 42

PNA Oral thrush Hoarseness Osteoporosis

Question 43

What treatment for COPD reduced mortalitiy?

Answer 43

Oxygen

Question 44

What treatment for COPD reduces mortality?

Answer 44

Oxygen

Question 45

For Acute Exacerbations of COPD, what is the mainstay of treatment?

Answer 45

ORAL corticosteroids

Question 46

For Acute Exacerbations of COPD, what is the mainstay of treatment?

Answer 46

ORAL corticosteroids

Question 47

What are some actions to take in order to prevent COPD exacerbations?

Answer 47

- Vaccinations | - Long acting bronchodilators and ICS

Question 48

What should you address at each visit with your COPD patient?

Answer 48

Smoking cessation

Question 49

LABA + LAMA = 2x the lung function but not 2x the?

Answer 49

Symptom improvement

Question 50

In effectiveness, is LABA = LAMA?

Answer 50

Yes