COPD

Question 1

What is Chronic Obstructive Pulmonary Disease?

Answer 1

A disease characterized by progressive development of airflow limitation, that is not fully reversible, and destruction of the lung parenchyma (alveoli, alveolar ducts and respiratory bronchioles)

Question 2

In COPD airflow limitation is?

Answer 2

Is progressive and associated with an inflammatory response of the lung to noxious particles or gases

Question 3

COPD is P_______

Answer 3

Preventable

Question 4

Primary Cause of COPD?

Answer 4

Tobacco Smoke

Question 5

Other risk factors of COPD?

Answer 5

1. Indoor air pollution (such as solid fuel used for cooking and heating)
2. Occupational dusts and chemicals (vapours, irritants & fumes)
3. Frequent lower respiratory infections incl. TB during childhood
4. Genetic conditions e.g. alpha 1 anti-trypsin deficiency (1-2%)
5. Poorly controlled Asthma

Question 6

COPD often coexists with ________ such as

Answer 6

other diseases such as CVD, osteoporosis, metabolic syndrome and lung cancer - a main cause of death

Question 7

3 Major signs of COPD?

Answer 7

1. Dyspnea
2. Chronic cough > 3 weeks
3. Sputum production

Question 8

What is Dyspnea?

Answer 8

Subjective sensation of uncomfortable breathing

Question 9

In advanced COPD C______ can occur which is _____

Answer 9

Cyanosis and bluish discoloration of the skin and mucous membranes

Question 10

What causes Cyanosis?

Answer 10

Develops at five grams of desaturated hemoglobin, regardless of concentration

Question 11

What is central cyanosis caused by?

Answer 11

Decreased arterial oxygenation, and best observed in buccal mucous membranes and lips

Question 12

What is the normal V/Q ratio?

Answer 12

0.8 - 0.9

Question 13

What is hypercapnia?

Answer 13

Increased (CO2) in the arterial blood, CO2 level > 45 mmHg

Question 14

How does hypercapnia occur?

Answer 14

Occurs from decreased drive to breathe or an inadequate ability to respond to ventilatory stimulation

Question 15

What is Hypoxemia & main cause?

Answer 15

Low O2 levels in blood
PaO2< 80mmHg
Main cause is V/Q abnormalities

Question 16

What is hypoxia?

Answer 16

Low O2 levels in tissues

Question 17

What is Emphysema?

Answer 17

A progressive lung disease where the tiny air sacs (alveoli) in the lungs are damaged, leading to difficulty breathing

Question 18

Symptoms of Emphysema?

Answer 18

• Dyspnea on exertion
• Later progresses to marked dyspnea, even at rest
• Little coughing and very little sputum
• Thin
• Tachypnea with prolonged expiration; use of accessory muscles for ventilation; pursed

Question 19

How are the alveoli destroyed in emphysema?

Answer 19

Occurs through the breakdown of elastin in the septa as a result of an imbalance between proteases and antiproteases, oxidative stress, and apoptosis of the lung’s structural cells

Question 20

Destruction of alveolar walls produces dilated air spaces and less?

Answer 20

Surface area for gas exchange

Question 21

Alveolar destruction also produces large __________

Answer 21

Air spaces within the lung parenchyma (bullae) and air spaces adjacent to the pleurae (blebs)

Question 22

Unsupported airways tend to___

Answer 22

Collapse on expiration

Question 23

Empyshea also leads to a_____ and decrease in e_______

Answer 23

Air trapping and elastic recoil

Question 24

Emphysema results in reduced lung elastic recoil pressure, which leads to a?

Answer 24

Reduced driving pressure for expiratory flow through narrowed and poorly supported airways in which airflow resistance is significantly increased

Question 25

This reduced elastic lung recoil causes?

Answer 25

Air trapping and hyperinflation, an abnormal increase in the volume of air remaining in the lungs at the end of spontaneous expiration

Question 26

What is the function of a-1-antitrypsin (AAT)?

Answer 26

1. It inhibits a wide variety of proteases 2. Protects tissues from neutrophil elastase

Question 27

What does neutrophil elastase do?

Answer 27

In it absence, neutrophil elastase is free to break down elastin which contributes to the elasticity of the lungs, resulting in emphysema

Question 28

In selected patients bronchoscopicmodes of lung volume reduction by?

Answer 28

Improving exhalation or volume reduction surgery may be considered for LUNG VOLUME REDUCTION (reduced hyperinflation)

Question 29

What is Chronic Bronchitis?

Answer 29

Recurrent or chronic productive cough for a minimum of 3 months for 2 consecutive years (e.g. smokers cough

Question 30

What is the pathophysiology of CB?

Answer 30

1. Chronic inflammation, episodic dyspnoea 2. Hypertrophy of bronchial glands that secrete mucus & increase number of mucus secreting goblet cells- mucus plugging 3. Cilia are destroyed 4. Increases airflow resistance + work of breathing 5. Hypoventilation & CO2 retention = hypoxemia & hypercapnia

Question 31

What is ventilatory function?

Answer 31

Measure lung volumes and pressures

Question 32

What does Diffusion of alveolar gases measure?

Answer 32

Gases in expired air and in the blood

Question 33

What does spiratory measure?

Answer 33

Measures air flow and lung volumes

Question 34

What is FEV1?

Answer 34

Forced expiratory volume in one second

Question 35

What is FVC?

Answer 35

The maximal amount of air that can be expired

Question 36

A postbronchodilator FEV1/FVC <0.7 indicates?

Answer 36

Airflow limitation

Question 37

Long-term oxygen therapy is indicated for stable patients who have:

Answer 37

1. PaO2 at or below 7.3 kPa (55 mmHg) or SaO2 at or below 88%, with or without hypercapnia, confirmed twice over three weeks 2. PaO2 between 7.3 kPa (55 mmHg) and 8.0 kPa (60 mmHg), or SaO2 of 88%

Question 38

What is the cause of pulmonary hypertension?

Answer 38

Partly due to hypoxic driven vasoconstriction in lungs to maintain V/Q ratios (to reduce mismatch), if

Question 39

Pulmonary H can lead to?

Answer 39

Leads to an increased afterload, thereby increasing the workload of the right ventricle and RV enlargement