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Clinical Pulm > Asthma and COPD > Flashcards

Asthma and COPD Flashcards

1
Q

are boys or girls more chance in childhood? puberty/

chance of remission?

A

Childhood: Boys>girls

Puberty/adulthood: women>men

1/3 will remission in children and 1/3 of those will remain remmissed throughout adult life

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2
Q

Prenatal asthma risk factors?

A

Prematurity

Ethnicity
low SES
stress
C section
Maternal smoking
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3
Q

Postnatal risk factors asthma?

A

levels of endotoxins and allergens within the home (dust mites)

Viral and bacterial infecctions
-RSV and adenovirus

air pollution

antibiotic

acetaminophen exposure

obesity

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4
Q

Clinical presentations of Asthma

A

Cough, recurrent wheezing, chest tightness and SOB

Worse at night, with excercise, viral infection, exposure to allergens and irritants, changes in the weather, laughing or crying stress

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5
Q

Does a normal Spirometry exclude the disease of asthma?

A

NO it does not!!

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6
Q

what are the spirometry reversibillity criteria

A

12% improvement of FEV1 over the baseline and a total improvement of at least 200ml

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7
Q

rule of 2s in asthma classifying?

A

to determine intermittent

symptoms less then 2 times a week

SABA less then 2 days a week

less then 2 nighttime awakenings

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8
Q

how to determine Mild persistent of asthma

A

> 2 days a week of symptoms

> 2 excaberations in 2 months

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9
Q

how to determine moderate persistence of Asthma

A

daily symptoms and use of SABA or limitation

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10
Q

how to determine severe persistence of asthma

A

Several times per day and extremely limited

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11
Q

What is the major goal of treatment and management of astham

A

Provide the best quality of life through minimizing disease symptoms and abolishing disease exacerbations

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12
Q

what is the asthma control test?

A

used to help patients to help determine if they need to ask the doctor about their asthma

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13
Q

How is intermittent asthma treated?

A

SABA as needed

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14
Q

How is mild perseistence asthma treated

A

low dose ICS

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15
Q

how is moderate persistent asthma treated?

A

low dose ICS and LABA

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16
Q

how is extreme persistent asthma treated

A

High dose ICS and LABA and maybe omalizumab

17
Q

What to treat astma exacerbation?

A

Bronchodilators, systemic glucocorticoids and O2

18
Q

is brestfeeding a preventative measure to asthma

A

yes

19
Q

what is the most common cause pf COPD and what is the next?

A

smoking/exposure to tobacco

history of Tuberculosis

20
Q

what are common symptoms to COPD acute exacerbations?

A

increased

  • dyspnea
  • sputum purulence
  • cough
  • wheezing
21
Q

what are some major comorbidities of COPD

A
  • CAD
  • Arrhythmias
  • HTN
  • HF
  • lung CA
  • depression and anxiety
  • metabolic syndrome
  • osteoprosis
22
Q

characteristics of a “Pink Puffer”

A

more emphysema

  • low BMI
  • less muscle mass
  • hyperinflation
  • low DLCO
  • decreased excercise capacity
  • worst health status
  • decreased sRAGEs
23
Q

characteristics of “Blue Bloater”

A

Less emphysema

  • High BMI
  • more metabolic co morbidities
  • cardiac compromise
  • OSA
  • less hyperinflation
  • increased excerbations
  • normal DLCO
  • high levels of inflammatory markers IL-6 and CRP
24
Q

what are the spirometry results of COPD: FEV1/FVC ratio, FEV1, reversibillity

A

FEV1/FVC

25
Q

what are the Gold standards for COPD

A

Based on the FEV1 of predicted

GOLD 1 = mild FEV> 80%

GOLD 2 = moderate > 50 FEV <80 %

GOLD 3 = severe <50 FEV >30 %

GOLD 4 = Very severe FEV < 30%

26
Q

what is the treatment of GOLD 4 COPD

A

Lung reduction or transplantation

27
Q

what are the 2 Nonpharmalogic treatmets of COPD

A

Pulmonary rehab

Lung volume reduction surgery and transplantation

28
Q

What are the Pharmacologic treatment of COPD

A

Bronchodilators

  • LABA and LAMA
  • improves lung function

ICS: for high risk of exacerbations
-improves lung function and decreases breathlessness

Oxygen:
-reduces mortality!!!

29
Q

what is the initial management of COPD

A

smoking cessation

vaccination

active lifestyle and exercise

Initial pharmacotherapy

management of co morbidities

30
Q

Treatment of acute exacerbations of COPD

A

Oral antibiotics

Oral corticosteroids

Oxygen if needed

LABA or LAMA for prevention

Clinical Pulm (5 decks)

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