COPD

Question 1

2 types of COPD

Answer 1

1. CB

2. emphysema

Question 2

def. CB

Answer 2

chronic cough of sputum for at least 3 months for 2 years

Question 3

def. emph

Answer 3

permanent enlargement of airspaces distal to terminal branches

Question 4

risk factors

Answer 4

1. smoking
2. asthma
3. a1 antitrypsin
4. env.

Question 5

Sx

Answer 5

any combo of cough, sputum prod., and dyspnea

Question 6

7 signs

Answer 6

1. prolonged FEV1
2. wheezes
3. tachypnea
4. cyanosis
5. use of acces. muscles
6. hyperresonance
7. signs of cor pulmonale

Question 7

Dx testing

Answer 7

1. PFT
   - FEV1/FVC less than 70%
2. CXR - low sens.
   - hyperinflation
   - diminished vascular markings
3. a1-antitrypisin levels

Question 8

Steps in Tx

Answer 8

1. quit smoking
   - prolongs, but never reverses
2. B2 agonsists
   - long acting salmeterol best
3. inhaled anti-cholinergist
   - ipatropium bromide
4. combine B2 and anti-chol
5. inhaled corticosteroids
6. O2
   - based on ABG - PaO2

Question 9

Tx for acute exacerbations

Answer 9

1. start with dilators
2. systemic steroids
3. ABx (PNA)
4. 02
5. BiPAP
6. intubate if necc.