COPD

Question 1

COPD is a ___________ lung condition

Answer 1

heterogenous

Question 2

COPD is characterized by chronic respiratory symptoms such as _____________

Answer 2

dyspnea, cough, sputum production and/or
exacerbation

Question 3

COPD is characterized by chronic respiratory symptoms due to abnormalities of the
_________ and/or __________ that cause persistent, often
progressive, airway obstruction

Answer 3

airways; alveoli

Question 4

T/F: COPD is a common, preventable and treatable

Answer 4

true

Question 5

T/F: COPD is usually caused by usually caused by significant
exposure to noxious particle or gas

Answer 5

True

Question 6

COPD causes

Answer 6

Smoking, air pollution, dust

Question 7

COPD symptoms

Answer 7

Constant shortness of breath,
chronic cough with mucus, fatigue,
chest tightness; worsen over time

Question 8

COPD may cause __________(permanent/temporary) narrowing due to lung
damage and destruction

Answer 8

permanent

Question 9

Is COPD irreversible or reversible?

Answer 9

Irreversible

Question 10

Usual treatment for COPD

Answer 10

Bronchodilators, steroids, oxygen
therapy to manage symptoms and
slowing disease progression

Question 11

Cough and sputum production for most days
over 3 months for 2 consecutive years

Answer 11

Chronic Bronchitis

Question 12

Thickened bronchial walls, hyperplastic and
hypertrophied mucus glands and mucosal
inflammation in the bronchial walls and airways

Answer 12

Chronic Bronchitis

Question 13

Enlargement of the airway

Answer 13

Emphysema

Question 14

Characterized by permanent destruction of the
alveoli as a result of irreversible destruction of
the elastin that maintains the strength of the
alveolar walls

Answer 14

Emphysema

Question 15

Causes of chronic bronchitis

Answer 15

Hypersecretion of mucus
Ciliary dysfunction

Question 16

increased size
of mucus glands and goblet
cells

Answer 16

Hypertrophy

Question 17

increased cell
or mucus production

Answer 17

Hyperplasia

Question 18

Ciliary dysfunction is an inflammation and damage
impair in the functions of cilia which may cause:

Answer 18

• Decreased motility
• Decreased length or size
• Decreased number

Question 19

Effects of bronchitis

Answer 19

• Formation of mucus plugs
• Air trapping
• Increased risks for infections

Question 20

failure to expel mucus due to
ciliary dysfunction

Answer 20

Mucus plug

Question 21

accumulation of excessive
mucus narrowing the airways
and obstructing airflow

Answer 21

Mucus plug

Question 22

decreased
oxygen levels in the blood

Answer 22

Hypoxemia

Question 23

increased
CO2 levels in the blood

Answer 23

Hypercapnia

Question 24

Possible pathogens involved in chronic bronchitis

Answer 24

Haemophilus influenzae
* Moraxella catarrhalis
* Staphyloccocus aureus
* Streptococcus pneumoniae

Question 25

Emphysema pathophysiology

Answer 25

triggers / irritants / pollutants ↓ phagocytosis by macrophages ↓ cytokine production ↓ activation of immune cells like neutrophils and macrophages ↓ production of proteases like elastase ↓ breakdown of elastin ↓ loss of airway recoil functions

Question 26

______________ brings back alveoli to its normal shape and size

Answer 26

elastin

Question 27

without _________ = permanent alveoli dilation

Answer 27

elastin

Question 28

Results to reduced gas exchange, air trapping, DOB

Answer 28

absence of elastin

Question 29

prevents elastase to breakdown elastin, keeping the airway recoil functions of the air sac

Answer 29

Alpha-1-antitrypsin

Question 30

Types of Emphysema

Answer 30

Centriacenar Panacinar Distal acinar or Paraseptal

Question 31

proximal respiratory airway

Answer 31

Centriacenar

Question 32

mostly in upper lung zones

Answer 32

Centriacenar

Question 33

most common type of pulmonary emphysema

Answer 33

Centriacenar

Question 34

distal respiratory airway; acinus and secondary lobule

Answer 34

Panacinar

Question 35

distal alveoli ducts and alveoli sacs

Answer 35

Distal acinar or Paraseptal

Question 36

COPD Risk factors

Answer 36

Smoking, Genetics, Frequentung infecton, Indoor smoke, Occupatonal dust and chemicals

Question 37

Most reproducible and objective measurement of air flow limitation or obstruction

Answer 37

Spirometry

Question 38

Can also be used to assess severity of airway obstruction

Answer 38

Spirometry

Question 39

Used for follow-up assessment in evaluation of current therapy

Answer 39

Spirometry

Question 40

Non-invasive and readily available

Answer 40

Spirometry

Question 41

Good sensitivity

Answer 41

Spirometry

Question 42

FEV1/FVC =

Answer 42

0.70 or 70%

Question 43

a genetic disease increasing the risk of a patient to lung, liver or skin

Answer 43

Alpha–1–antitrypsin Deficiency

Question 44

Not routinely performed but only to rule out other respiratory conditions that may progress or lead to COPD

Answer 44

Imaging

Question 45

T/F: Chest X-ray is not useful to establish COPD

Answer 45

True

Question 46

Radiological changes include:

Answer 46

lung hyper infiltration; hyperlucency of the lungs and tapering of vascular markings

Question 47

CT is not routinely recommended except for detection of __________________ and COPD patients that meets criteria for ______________

Answer 47

bronchiectasis, lung cancer risk assessment

Question 48

Body Paleothermometer or Helium dilution lung volume measurement

Answer 48

Lung volume and diffusing capacity

Question 49

Help characterize severity of COPD but are not essential for patient management

Answer 49

Lung volume and diffusing capacit

Question 50

Measurement of Diffusing Capacity provides information on the functional impact of emphysema in COPD and is useful in patients with breathlessness that may seem out of proportion to the degree of airflow

Answer 50

Lung volume and diffusing capacity

Question 51

can be used to evaluate patient’s arterial oxygen saturation

Answer 51

Oximetry and Arterial Blood Gas Measurement

Question 52

Used to assess all patients with clinical signs suggestive of respiratory failure and right-sided heart failure

Answer 52

Oximetry and Arterial Blood Gas Measurement

Question 53

If peripheral arterial oxygen saturation is _____________ arterial or capillary blood gas must also be measured

Answer 53

< 92%,

Question 54

Objectively measures patient exercise or physical activity impairment caused by airway obstruction

Answer 54

Exercise Testing and Assessment of Physical Activity

Question 55

method gives a composite score that is a better predictor of subsequent survival

Answer 55

BODE (Composite score)

Question 56

Objectively measures and evaluates as indicator of normal biological or pathogenic process or pharmacologic intervention

Answer 56

Biomarkers

Question 57

* Group A

Answer 57

* Bronchodilator (LABA or SABA)

Question 58

Group B

Answer 58

LABA + LAMA combination in a single inhaler therapy

Question 59

Group E

Answer 59

LABA + LAMA combination in a single inhaler therapy LABA + LAMA + ICS * Only if eosinophil ≥ 300

Question 60

Bronchodilators ________ (increase/decrease) FEV1

Answer 60

Increase

Question 61

Bronchodilators are most often given regularly to

Answer 61

prevent or reduce symptoms

Question 62

The use of __________-acting bronchodilators on regular bases is not generally recommended

Answer 62

short

Question 63

(bronchodilators) = more effective when given in combination

Answer 63

SABA + SAMA

Question 64

(bronchodilators) – improves lung function, reduces dyspnea symptoms and exacerbations and improves patient status

Answer 64

LABA, LAMA

Question 65

Relaxation of the smooth muscle of the airway

Answer 65

Beta-2 Agonists

Question 66

* Block bronchoconstrictor effect of Acetylcholine on the muscarinic receptor on the air way smooth muscle

Answer 66

Antimuscarinic Drugs

Question 67

SAMA

Answer 67

Ipratropium and Oxitropium

Question 68

Greater effect on reducing exacerbation, hospitalization

Answer 68

LAMA

Question 69

T/F: LAMA is given in combination with LABA, not as monotherapy

Answer 69

True

Question 70

Tiotropium, Aclidnium, Glycopyrronium Bromide, Umeclidinium

Answer 70

LAMA

Question 71

Most commonly used methylxanthine

Answer 71

Theophylline

Question 72

Exerts a small bronchodilation on patients with stable COPD

Answer 72

Methylxanthine

Question 73

Requires a larger dose to exert effect

Answer 73

Methylxanthine

Question 74

More effective if combined with LABA and LAMA in improving lung function and health status and reducing exacerbation

Answer 74

Inhaled Corticosteroid

Question 75

Only when the patient has medical history of asthma

Answer 75

Inhaled Corticosteroid

Question 76

Regular treatment with ICS increase risk of _____________

Answer 76

pneumonia

Question 77

Treatment with_____________ improves lung function, symptoms and health status and reduce exacerbation

Answer 77

ICS/LAMA/LABA

Question 78

Long-term used is associated with numerous side effect

Answer 78

Oral Glucocorticoid

Question 79

Used in patients with chronic bronchitis, severe to very severe COPD and history of exacerbation

Answer 79

PDE4 Inhibitor

Question 80

Improves lung function and reduces moderate and severe exacerbation in patients with ICS-LABA medications

Answer 80

PDE4 Inhibitor

Question 81

Long-term _______ and _________ therapy reduces exacerbation over one yea

Answer 81

azithromycin and erythromycin

Question 82

Use of ____________ is associated with and increased incidence of bacterial resistance

Answer 82

Azithromycin

Question 83

* Regular treatment with _____________agents reduces risk of exacerbation and relieves cough symptoms of COPD patients

Answer 83

anti-mucolytic