[COPD] Flashcards
(69 cards)
1
Q
A
80
2
Q
A
0.7
3
Q
A
the % of FVC which is expired in 1 second at maximum expiration
4
Q
A
>=0.8
5
Q
A
Reduced due to reduced air escaping
6
Q
A
Normal (or increased)
7
Q
A
in restrictive there is an equal reduction of FVC and FEV1 due to lung pathology. Sometimes the FEV1 may even be raised due to decreased compliance.
8
Q
A
cough + sputum production for most days for 3 months of 2 consecutive years
9
Q
A
cough + sputum production for most days for 3 months of 2 consecutive years
10
Q
A
enlarged air spaces distal to terminal bronchioles + destruction of alveolar walls
11
Q
A
enlarged air spaces distal to terminal bronchioles + destruction of alveolar walls
12
Q
A
Pink puffer Blue bloater
13
Q
A
increased
14
Q
A
decreased
15
Q
A
Pink puffer
16
Q
A
Blue bloater
17
Q
A
high
18
Q
A
low
19
Q
A
normal or low
20
Q
A
near normal
21
Q
A
the hypoxic drive
22
Q
A
CO2 (relatively)
23
Q
A
Type 1 respiratory failure
24
Q
A
cor pulmonale
25
[COPD]: why is giving oxygen to a blue bloater potentially dangerous
deprives them of their hypoxic drive leading to extreme hypercapnia
26
[COPD]: why is giving oxygen to a blue bloater potentially dangerous
deprives them of their hypoxic drive leading to extreme hypercapnia/acid base imbalance
27
[COPD]: give 4 symptoms of COPD
cough sputum wheeze dyspnoea (SOB)
28
[COPD]: give 5 signs of COPD
accessory muscles
Tachypnoea
hyperinflation (cricosternal distance\<3cm)
resonant/hyperresonant
cor pulmonale
29
[COPD]: give 5 signs of COPD
accessory muscles Tachypnoea hyperinflation (cricosternal distance
30
[COPD]: give 3 complications of COPD
polycythaemia Cor pulmonale pneumothorax
31
[COPD]: what can cause a pneumothorax in the context of COPD
ruptured bullae (thin walled sac of air)
32
[COPD]: what causes polycythaemia
increased EPO due to 2ry hypoxia
33
[COPD]: what is cor pulmonale
right heart failure
34
[COPD]: what causes cor pulmonale
chronic pulmonary arterial hypertension
35
[COPD]: what would be noticed on the central pulmonary arteries
enlarged
36
[COPD]: give 2 signs of hyperinflation
flat hemidiaphragms \>6 anterior ribs seen above diaphragm in mid-clavicular line (assess adequacy of inspiration)
37
[COPD]: what is this x-ray showing
normal inflation - anterior end of 7th rib above diaphragm (less than 6 = impaired expansion; \>7 suggest hyperinflation)
38
[COPD]: right atrial and ventricular hypertrophy is indicative of ...
cor pulmonale
39
[COPD]: what would lung function tests show? (2)
FEV1 \<80% of predicted
FEV1:FVC \<70% (0.7)
40
[COPD]: What is the cause of 'barrel chest' (large front to back diameter)
Hyperinflation
41
[COPD]: on Ix what would be seen in relation to TLC
increased TLC
42
[COPD]: what does DLCO stand for
diffusing capacity of the lung for carbon monoxide
43
[COPD]: there is reduced DLCO in which COPD disease
emphysema
44
[COPD]: what does DLCO measure
the extent to which O2 diffuse from the alveoli in to the RBCs
45
[COPD]: which disease can cause and increase in DLCO
polycythaemia
46
[COPD]: Tx: what lifestyle advice should you give
smoking cessation
exercise
47
[COPD]: Tx: when is long term O2 therapy indicated (LTOT)
if PaO2 is \<7.3kPa
48
[COPD]: Tx: what is 1st line drug Tx for with COPD less severe than 'mild' severity (2)
Salbutumol
OR
Ipatropium (short acting)
(as needed)
49
[COPD]: Tx: what is 1st line Tx for 'mild/moderate' COPD (2)
Tiotropium (long acting)
or
Salbutumol
50
[COPD]: Tx: what is the Tx options for severe COPD (30-49% of FEV1) (3)
Salbutumol
+
corticosteroid
(i.e. symbicort)
OR
Tiotropium
51
[COPD]: Tx: what are the treatment options for severe COPD sufferers who are unresponsive to the appropriate Tx?
Tiotropium
+
salbutumol
+
corticosteroid
52
[COPD]: Tx: what is is contained in the compound drug symbicort (2)
budesonide
+
Formoterol
(long acting)
53
[COPD]: Tx: at what stage should you refer to a specialist?
Symptomatic after adminstration of 'severe' stage drugs
54
[COPD]: Tx: how does tiotrpoiuum work
M3 antimuscarinic - long acting smooth muscle relaxation
55
[COPD]: Tx: how does salbutumol work?
short acting B2 adrenergic agonist causing smooth muscle relaxation
56
[COPD]: Dx: define Stage 1 'general' COPD
FEV1 \>=80%
57
[COPD]: Dx: define stage 2 'mild/moderate' COPD
FEV1 50-79% of predicted
58
[COPD]: Dx: define stage 3 'severe' COPD
FEV1 30-49% of predicted
59
[COPD]: Tx: what is 'steroid responsive COPD'
2 week trial of prednisolone
FEV1 rises by \>15%
long-term steroid may be helpful
60
[COPD]: Tx: what is the cut off for LTOT in stable non-smokers
\<7.3 kPa
61
[COPD]: Tx: what are the criteria for delivering LTOT at a kPa of 7.3-8.0 O2? (4)
pulmonary hypertension (loud s2/LVH)
Polycythaemia
peripheral oedema
nocturnal hypoxia
62
[COPD]: Ix: what would you expect on an ABG
low PA02
hypercapnic
63
[COPD]: Tx: what are the 2 indications for surgery
recurrent pneumothoraces
isolated bullae
64
[COPD]: What are bullae and how are they caused (2)
air filled sac
one way valve
(compressive effects)
65
[COPD]: what disease is associated with pink puffers
emphysema
(damagaged alveoli walls + reduced blood flow)
66
[COPD]: what disease is associated with blue bloaters
chronic bronchitis
(increased mucus production = obstructed airways = reduced ventilation)
67
[COPD]: what is the role of pulmonary surfacant (2)
reduces water surface tension
increased lung compliance
68
[COPD]: Dx: define stage 4 'very severe' COPD
FEV1 \<30% of predicted
69
[COPD]: LTOT is given if the patients meets the criteria twice, ... weeks apart
\>3
