COPD

Question 1

heavy sputum production that improves and worsens is characteristic of what disease

Answer 1

chronic bronchitis

Question 2

which obstructive disease has a chief symptom of dyspnea

Answer 2

emphysema

Question 3

what are some later signs of COPD

Answer 3

barrel chest
nail clubbing
right sided HF
polycythemia

Question 4

who should be screened for COPD

Answer 4

those with symptoms any any smokers or ex smokers over age 40

Question 4

how will results of PFT post bronchodilator differ in a COPD patient compared to an asthma patient

Answer 4

COPD will have much less improvement post bronchodilator

Question 5

if there is no history of exposure risk factors for COPD, what blood test should be done

Answer 5

alpha-1 antitrypsin deficiency

Question 6

what breath sounds would you expect with chronic bronchitis

Answer 6

wheezing and rhonchi that partially clear with coughing

Question 7

enlarged air sacs are seen in which kind of COPD

Answer 7

emphysema

Question 8

what are the main causes of AECOPD

Answer 8

URTI and medication non compliance

Question 9

what is cor pulmonale and what causes it

Answer 9

pulmonary vasoconstriction from hypoxemia leads to pulmonary HTN leads to right sided heart failure

Question 10

what systemic symptoms will be seen with right heart failure

Answer 10

JVD
hepatomegaly
ascites
pedal edema

Question 11

right heart failure and polycythemia is more common with chronic bronchitis or emphysema and why

Answer 11

chronic bronchitis
more common to have hypoxemia

Question 12

what would you see on a CBC for polycythemia

Answer 12

increased Hg, RBC, and hematocrit

Question 13

chronic bronchitis or emphysema may cause a spontaneous pneumothorax

Answer 13

emphysema

Question 14

a pt with COPD presents with sudden onset dyspnea, and absent lung sounds on one side. What do they have and what kind of COPD is most likely

Answer 14

spontaneous pneumothroax
emphysema

Question 15

what would a CXR show in COPD

Answer 15

barrel chest, hyperinflation, flat diaphragm

Question 16

how do you diagnose COPD

Answer 16

PFTs

Question 17

what should your O2 goal be in COPD and why

Answer 17

88-92% because chronic hypoxemia will lead to right sided heart failure

Question 18

what are the indications to start O2 therapy

Answer 18

O2 <88%
cor pulmonale
O2 <90% WITH polycythemia

Question 19

what are the goals of therapy in COPD

Answer 19

alleviate dyspnea
improve health status
prevent AECOPD
reduce mortality

Question 20

what are the steps for treatment for COPD

Answer 20

1: SABA PRN
2: add LABA/LAMA
3: add ICS
4: add oxygen

Question 21

Salbutamol is what class of medication

Answer 21

SABA

Question 22

ipratroprium is what class of medication

Answer 22

SAMA

Question 23

tiotropium is what class of medication

Answer 23

LAMA

Question 24

formoterol is what class of medication

Answer 24

LABA

Question 25

roflumilast is what class of medication

Answer 25

PDE4 inhibitor

Question 26

what are the predicted FEV1 score classifications for GOLD 1-4

Answer 26

Gold 1 = FEV1 >/= 80% Gold 2 50-80% Gold 3 30-50% Gold 4 <30%

Question 27

what is the most important therapuetic intervention for COPD management

Answer 27

quitting smoking

Question 28

what are common presenting symptoms of COPD

Answer 28

chronic colorless productive cough worse in the morning dyspnea wheezing weight loss

Question 29

why should you be cautious when using beta blockers in COPD

Answer 29

at high doses, it may cause bronchospasm

Question 30

how often should stable COPD clients be seen

Answer 30

Q1-2 months