COPD Part 1

Question 1

is a preventable and treatable slowly progressive respiratory disease of airflow obstruction

Answer 1

Chronic Obstructive Pulmonary Disease

Question 2

COPD involves

Answer 2

airways, pulmonary parenchyma, or both

Question 3

parenchyma includes any form of lung tissue, including

Answer 3

Bronchioles, bronchi, blood vessels, interstitium and alveoli

Question 4

Is copd reversible?

Answer 4

Irreversble, not fully reversible

Question 5

Most patients with COPD present with overlapping signs and symptoms of _____ that can cause airflow obstruction

Answer 5

emphysema and chronic bronchitis

Question 6

Other diseases classified as COPD

Answer 6

cystic fibrosis (CF), bronchiectasis, and asthma

Question 7

are the fourth leading cause of death for people of all ages in the United States

Answer 7

COPD and lower respiratory diseases

Question 8

they are the third leading cause of death for people ages 65 and over

Answer 8

COPD and lower respiratory diseases

Question 9

What age do COPD become symptomatic

Answer 9

Middle adult years, disease increases with age

Question 10

COPD inflammatory response occurs throughout

Answer 10

Proximal airway and peripheral airway, and lung parenchyma and pulmonary vasculature

Question 11

a disease of the airways, is defined as the presence of cough and sputum production for at least 3 months in each of 2 consecutive years.

Answer 11

Chronic bronchitis

Question 11

imbalances of these substances in the lung may also contribute to airflow limitation

Answer 11

Proteinases and antiproteinases

Question 12

play an important role in destroying foreign particles, including bacteria.

Answer 12

Macrophages

Question 13

impaired oxygen and carbon dioxide exchange results from destruction of the walls of overdistended alveoli.

Answer 13

Emphysema

Question 14

is a pathologic term that describes an abnormal distention of the airspaces beyond the terminal bronchioles and destruction of the walls of the alveoli

Answer 14

Emphysema

Question 15

one of the complications of emphysema, is right-sided heart failure brought on by longterm high blood pressure in the pulmonary arteries.

Answer 15

Cor pulmonale

Question 16

high pressure in the pulmonary arteries and right ventricle lead to back up of blood in the venous system, resulting in

Answer 16

dependent edema, distended neck veins, or pain in the region of the liver

Question 17

two main types of emphysema, based on the changes taking place in the lung. Both may occur in same pt.

Answer 17

Panlobular (panacinar) and Centrilobular (centroacinar)

Question 18

panlobular (panacinar) type of emphysema, there is destruction of the

Answer 18

respiratory bronchiole, alveolar duct, and alveolus

Question 19

All airspaces within the lobule are essentially enlarged, but there is little inflammatory disease.

Answer 19

Panlobular (panacinar)

Question 20

Typically occurs with panlobular emphysema

Answer 20

hyperinflated (hyperexpanded) chest, marked dyspnea on exertion, and weight loss

Question 21

Instead of being an involuntary passive act, expiration becomes active and requires muscular effort.

Answer 21

Panlobular emphysema

Question 22

pathologic changes take place mainly in the center of the secondary lobule, preserving the peripheral portions of the acinus

Answer 22

Centrilobular (centroacinar)

Question 23

the terminal airway unit where gas exchange occurs

Answer 23

Acinus

Question 24

Centroacinar emphysema has a derangement of ventilation–perfusion ratios, producing

Answer 24

chronic hypoxemia, hypercapnia, polycythemia and episodes of right-sided heart failure which leads to central cyanosis and respiratory failure. The patient also develops peripheral edema

Question 25

Risk factors for COPD include

Answer 25

environmental exposures and host factors

Question 26

The most important environmental risk factor for COPD worldwide is

Answer 26

cigarette smoking

Question 27

environmental risk factors

Answer 27

smoking other types of tobacco (e.g., pipes, cigars) and marijuana Secondhand smoke prolonged and intense exposure to occupational dusts and chemicals indoor air pollution, and outdoor air pollution electronic nicotine delivery systems low socio economic status

Question 28

Host risk factors

Answer 28

person’s genetic makeup * alpha1-antitrypsin deficiency *gene–environment interactions Age

Question 29

depresses the activity of scavenger cells and affects the respiratory tract’s ciliary cleansing mechanism, which keeps breathing passages free of inhaled irritants, bacteria, and other foreign matter

Answer 29

Smoking

Question 30

irritates the goblet cells and mucous glands, causing an increased accumulation of mucus, which in turn produces more irritation, infection, and damage to the lung

Answer 30

Smoking

Question 31

by-product of smoking

Answer 31

Carbon monoxide

Question 32

a by-product of smoking combines with hemoglobin to form

Answer 32

carboxyhemoglobin

Question 33

an enzyme inhibitor that protects the lung parenchyma from injury. This deficiency may lead to lung and liver disease.

Answer 33

alpha1-antitrypsin deficiency

Question 34

How many percent of people with COPD have been diagnosed with this deficiency

Answer 34

2%

Question 35

This deficiency predisposes young people to rapid development of lobular emphysema, even in the absence of smoking.

Answer 35

alpha1-antitrypsin deficiency

Question 36

slows the progression of the disease, is available for patients with this genetic defect and for those with severe disease.

Answer 36

Alpha-protease inhibitor replacement therapy,

Question 37

often identified as a risk factor for COPD, but it is unclear whether is an independent risk or whether the risk is related to cumulative exposures to risks over time

Answer 37

Age

Question 38

at risk for increased patterns of exposure (indoor and outdoor pollutants, crowding, poor nutrition, infections, and increased smoking).

Answer 38

lower socioeconomic status

Question 39

three primary symptoms

Answer 39

chronic cough, sputum production, and dyspnea

Question 40

often precede the development of airflow limitation by many years.

Answer 40

Chronic cough and sputum production

Question 41

may be severe and interfere with the patient’s activities and quality of life. It is usually progressive, worse with exercise, and persistent.

Answer 41

Dyspnea

Question 42

is common, because dyspnea interferes with eating and the work of breathing is energy depleting

Answer 42

Weight loss

Question 43

This configuration results from a more fixed position of the ribs in the inspiratory position (due to hyperinflation) and from loss of lung elasticity

Answer 43

“barrel chest” thorax configuration

Question 44

systemic or extrapulmonary manifestations of COPD

Answer 44

musculoskeletal wastingmetabolic disturbances, and depression

Question 45

a frequent comorbidity that accompanies chronic debilitating illnesses

Answer 45

Depression

Question 46

are frequent comorbidities of COPD

Answer 46

depression, metabolic syndrome, and diabetes

Question 47

may ameliorate metabolic syndrome, diabetes, and depression may also deter the development of COPD

Answer 47

promote healthy eating and activity

Question 48

Cinical manifestations

Answer 48

chronic cough, sputum production, and dyspnea Weight loss Use of accessory muscles Barrel chest musculoskeletal wasting, metabolic disturbances, and depression Diabetes

Question 49

are recruited in an effort to breathe as the work of breathing increases over time

Answer 49

Use of accessory muscles