COPD

Question 1

What is COPD?

Answer 1

Preventable and treatable disease characterized by persistent respiratory symptoms and airflow limitation

Question 2

What are the main environmental exposure for COPD?

Answer 2

Tobacco smoke and the intimation. Of tocix particles and gases from household or outside pollution

Question 3

What are the rare genetic risk factors for CPOD?

Answer 3

Mutation in the SERPINA1 gene that leads to alpha 1 antitrypsin deficiency

Question 4

What is the leading cause of death worldwide?

Answer 4

COPD

Question 5

What is the most common risk factor of COPD?

Answer 5

Tobacco smoke

Question 6

What is required to make the diagnosis?

Answer 6

Spirometry

Question 7

What evaluation confirms COPD?

Answer 7

FEV1/FVC< 0.70

Question 8

What are disorders that cause symptoms close to COPD?

Answer 8

Asthma, HF, broncheoctasis, TB, obliteration bronchitis, and diffuse panbroncholitis

Question 9

What are the 4 pharmacological management parameters for COPD?

Answer 9

1. Severity of airflow limitation
2. Nature and magnitude of current symptoms
3. Previous hx of moderate band severe exacerbations
4. Presence and type of other diseases (multimorbidity)

Question 10

What are the front line treatments for COPD?

Answer 10

Ipatropium short acting
Tiotropium long acting
Aclidinium bromide long acting
Umeclidinum long acting
Glycopyrrolate long acting

Question 11

What are the PD of the front line COPD drugs?

Answer 11

Block muscadine cholinergic receptors in the bronchi and promotes bronchodilation

Question 12

What are the adverse effects of the front line COPD drugs?

Answer 12

Dry mouth
Irritation of the pharynx
Headache

Question 13

What are the main risk factors for COPD?

Answer 13

Tobacco smoke
Environmental exposure
Rare Genetic variants
Abnormal lung development
Accelerated lung aging

Question 14

What do exacerbation and comorbities contribute to in COPD?

Answer 14

contributes to overall severity, morbidity and mortality.

Question 15

What does airflow obstruction result from?

Answer 15

Small airway disease (obstructive bronchitis)
Lung tissue destruction (emphysema)

Question 16

What is important to remember regarding inflammatory structural changes?

Answer 16

It increases with disease severity and persistent after smoking cessation through unknown mechanisms.

Question 17

What does smoking during pregnancy increase risk of?

Answer 17

affects fetal lung growth and development in utero and possibly the priming of the immune system

Question 18

what are the environmental risk factors for COPD?

Answer 18

Indoor burning of wood
Animal dung
Crop residues
Coal

Question 19

What are the best estimates of prevalence of COPD?

Answer 19

presence of airflow limitation as demonstrated by pre and post bronchodilator spirometry rather than simply self-reported symptoms or clinician diagnosis data

Question 20

What are the characteristics of COPD?

Answer 20

Dyspnea
Wheezing, chest tightness
Fatigue, activity limitation
Chronic cough and/or sputum production
Periods of increase symptoms (exacerbations)

Question 21

What is the key symptoms of an exacerbations?

Answer 21

Increased dyspnea

Question 22

Exacerbations are often associated with?

Answer 22

Local and systemic inflammation caused by infection, pollution, or other insult to the airways

Question 23

What is the classification of COPD Gold 1?

Answer 23

Mild; FEV >/= 80% predicted

Question 24

What is the classification of COPD Gold 2?

Answer 24

Moderate; 50% </= FEV < 80% predicted

Question 25

What is the classification of COPD Gold 3?

Answer 25

Severe; 30%

Question 26

What is the classification of COPD Gold 4?

Answer 26

Very severe; FEV < 30% predicted

Question 27

What questionnaire tool has been used to measure COPD?

Answer 27

COPD Assessment Test (CAT)

Question 28

Gold guidelines suggest what score on the CAT assessment indicates symptomatic COPD?

Answer 28

>/= 10

Question 29

When determining pharmacologic management of COPD how should the patient be classified?

Answer 29

Group A, Group B, or Group E

Question 30

What is Group A?

Answer 30

Less symptomatic, low risk for future exacerbations (zero - 1 exacerbations per year without hospitalization) Cat < 10

Question 31

What is Group B?

Answer 31

More symptomatic, low risk of future exacerbations (zero to one exacerbation per year without hospitalization) CAT >/= 10

Question 32

What is Group E?

Answer 32

High risk of future exacerbations >/= exacerbation per year or >/= hospitalizations for exacerbations

Question 33

What is the goal of COPD?

Answer 33

reduce both current symptoms and future risks of exacerbations

Question 34

What is the management cycle of COPD?

Answer 34

Review: - symptoms - Dyspnea - Exacerbations Assess - Inhaler technique/adherence - Non-pharmacologic approaches Adjust - Escalate - Switch inhaler devise or molecule size - De-escalate

Question 35

When should long term O2 be given?

Answer 35

if hypoxemia is present, PaO2