COPD (ClinCon)

Question 1

Chief complaint in the case

Answer 1

Dyspnea

Question 2

Age and gender of patient in the case

Answer 2

60 y/o male

Question 3

Medical History

Answer 3

• frequent Pneumonitis
• controlled hypertension
• no known allergies

Question 4

How many packs of cigarettes he consumed in a year?

Answer 4

130 packs

Question 5

In social and family history of the patient, which of his relatives has emphysema

Answer 5

Father

Question 6

Inflammatory cells found in COPD

Answer 6

Neutrophil
CD 8+
Lymphocytes
Macrophages

Question 7

Which is reversible? Asthma or COPD?

Answer 7

Asthma

Question 8

True or False

Pursed lip breathing occurs in emphysema not in chronic bronchitis

Answer 8

True

Question 9

Known as pink puffer

Answer 9

Emphysema

Question 10

Aka blue bloater

Answer 10

Chronic bronchitis

Question 11

Characterized by mild dyspnea, copious sputum, frequent infections, hypercapnia and hypoxemia

Answer 11

COPD

Question 12

Final Diagnosis of the case

Answer 12

Emphysema

Question 13

What part of the lungs gas exchange occurs?

Answer 13

Alveolar sacs

Question 14

Pulmonary function test shows decreased maximal airflow rates during forced expiration

Answer 14

Obstructive dse

Question 15

Increase resistance to airflow from trachea and larger bronchi to terminal and respiratory bronchioles

Answer 15

Obstructive dse

Question 16

Most commonly known genetic risk factor for emphysema

Answer 16

Alpha 1 antitrypsin

Question 17

Characterized by irregular irreversible enlargement of air spaces distal to terminal bronchiole and destruction of walls without obvious fibrosis

Answer 17

Emphysema

Question 18

Type of emphysema where acini are uniformly enlarged from the level of respiratory bronchiole to the terminal alveoli. Associated with alpha 1 antitrypsin deficiency

Answer 18

Panacinar

Question 19

Type of emphysema where proximal portion of the acinus is normal, distal part is predominantly involves. Probably underlies cases of spontaneous pneumothorax in young adults

Answer 19

Paraseptal

Question 20

Type of emphysema which is often associated with chronic bronchitis

Answer 20

Centriacinar

Question 21

Type of emphysema which is almost invariably associated with scarring

Answer 21

Irregular

Question 22

Characteristics of centriacinar emphysema

Answer 22

Distal alveoli are sparred

Central or proximal part of acini are affected

Question 23

What type of emphysema is predominantly seen on heavy smokers?

Answer 23

Centriacinar

Question 24

Principal source of cellular protease

Answer 24

Neutrophils

Question 25

When can we call that the xray findings is only emphysema?

Answer 25

When hyperinflation is associated with blebs and paucity of vascular markings in the outer third of the film?

Question 26

Goals of COPD management

Answer 26

Improve current control Relieve symptoms Improve exercise tolerance Improve health status

Question 27

Defined clinically as persistent cough with sputum production for least 3 mos in at least 2 consecutive years, in the absence of any other identifiable cause.

Answer 27

Chronic bronchitis

Question 28

Earliest feature of chronic bronchitis

Answer 28

Mucus hypersecretion

Question 29

What are the recurrent episodes of asthma?

Answer 29

- wheezing - breathlessness - chest tightness - cough

Question 30

Type of infection associated with bronchiectasis

Answer 30

Chronic necrotizing infection

Question 31

Permanent dilatation of bronchi and bronchioles caused by destruction of muscle and supporting elastic tissue

Answer 31

Bronchiectasis

Question 32

Two processes that are crucial and intertwined in the pathogenesis of bronchiectasis

Answer 32

Obstruction and chronic persistent infection

Question 33

Type of study in COPD

Answer 33

Comparative study (qualitative)

Question 34

What is the hypothesis of the study?

Answer 34

Age should not be a barrier to the benefits of pulmonary rehabilitation in COPD

Question 35

Program duration of the study

Answer 35

8 weeks

Question 36

What is patient distribution in group a and group b?

Answer 36

``` Group a (below 70) - 202 Group b (>70) - 122 ```

Question 37

True or False | There is significant difference in PR in outcomes between Group A and group B using absolute values

Answer 37

False: no significance

Question 38

True or False | The study suggests that benefits of PR in COPD ate not age dependent

Answer 38

True

Question 39

Explains the effect of cigarette smoking in the production of centriacinar emphysema

Answer 39

Protease-antiprotease hypothesis

Question 40

Three risk factors of COPD

Answer 40

- smoking - environmental - occupational

Question 41

Prevalence of COPD in the philippines

Answer 41

14% (age 40 and above)

Question 42

Two types of COPD often co exist

Answer 42

Emphysema and chronic bronchitis

Question 43

Characterized by barrel chest

Answer 43

Emphysema

Question 44

COPD type B

Answer 44

Chronic bronchitis

Question 45

Examples of inflammatory mediators seen in chronic bronchitis

Answer 45

Histamine and IL-13

Question 46

What drug was given to the patient?

Answer 46

Salbutamol + ipatropium bromide nebule