COPD

Question 1

def. COPD

Answer 1

resp. disorder mainly caused by smoking, characterized by progressive and partially reversible airway obst. and lung hyperinflation, systemic manifestations, and increasing freq. and severity of exacerbations.

Question 2

def. chronic bronchitis

Answer 2

excess mucous secretions in thebronchial tree on most days for at least 3 months of the year for at least 2 years

Question 3

def. emphysema

Answer 3

lung condition char by abnormal, permanent, enlargement of the airspace distal to the terminal bronciole, acompanied by wall destruction without fibrosis

Question 4

what is COPD epi

Answer 4

only major cause of death on the rise

F>M

Question 5

6 steps to approach to COPD

Answer 5

1. diagnosis
2. preventative measures
3. pharma
4. non-pharma
5. prevention of AECOPD
6. surgical

Question 6

**2 requirements for COPD diagnosis

Answer 6

1. post dilator FEV1

Question 7

3 major physio changes in COPD

Answer 7

1. mucous hypersecretion
2. ciliary dysfunciton
3. airflow obstruction

Question 8

4 Sx of COPD

Answer 8

1. cough
2. wheeze
3. sputum
4. dyspnea

Question 9

what are 5 grades of COPD

Answer 9

1. breathless with strenous excercise
3. walks slower than others their age and stops for breath
   4
4. can’t leave house and breatheless when dressing

Question 10

what is better approach to prognosos

Answer 10

functiontional grade

- better than FEV1

Question 11

what is best thing can do for COPD

Answer 11

quit smoking

- earlier better

Question 12

4 classes of meds for COPD

Answer 12

1. inhaled bronchdilators
2. oral bronchdilators
3. anti-inflammatory
4. oxy

Question 13

4 types of inhaled dilators

Answer 13

1. short acting antichol
2. long acting antichol
3. short acting beta-agon
4. LABA

Question 14

what is the problem with hyperinflation

Answer 14

increased residual volume leads to less VC

Question 15

what is air trapping

Answer 15

• results in increased work of breathing
• places resp. muscles at a diadvantage
• contributes t feeling of dyspnea

Question 16

how do anti-cholinergics (tiotropium) work

Answer 16

lowers the FRC

Question 17

what is use for dilators

Answer 17

• for Sx only

- may help reduce hyperinflation

Question 18

when to use inhaled steroids

Answer 18

NOT as a first line or monotherapy

• may delay decline in QOL
• decrease freq. of exacerbations
• can be added to LABA

Question 19

what is use for PDEi’s

Answer 19

• non specific
• increase cAMP, bronchodilation
• anti-inflammatory
• blocks adenosine-r

Question 20

benefits of pulmonary rehab

Answer 20

• reduced dyspnea
• increase exercise cap.
• inprove QOL
• reduced admissions
• less leg discomfort

Question 21

what is use of oxygen therapy

Answer 21

must be used 24hrs a day to be useful for survival benefit

Question 22

what is AECOPD def.

Answer 22

sustained worsening of dyspnea, cough or sputum excretion, leading to an increased use in meds

Question 23

5 Tx of AECOPD

Answer 23

1. optimize bronchodilation
2. avoid resp. irritants
3. O2 as needed
   4 SYSTEMIC steroids
4. AB if purulent

Question 24

see table

Answer 24

soso