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Flashcards in COPD test questions Deck (61):
1

VT

Normal or increase

2

IRV

Normal or decrease

3

ERV

Normal or decrease

4

RV

Increase

5

VC

Decrease

6

IC

Normal or decrease

7

FRC

Increase

8

TLC

Normal or increase

9

RV/TLC ratio

Normal or increase

10

What emphysema is genetic or inherited?

Panlobular

11

What emphysema results from cigarette smoking?

Centrilobular

12

_____ is a preventable and treatable disease state characterized by airflow limitation that is not fully _____.

COPD; reversible

13

_____ is defined clinically as a chronic productive cough for 3 months in each of 2 successive years in a patient in whom other causes of productive chronic cough have been excluded.

Chronic bronchitis

14

____ is defined pathologically as the presence of permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.

Emphysema

15

What is based on the major "clinical manifestations" associated with the disease?

Chronic bronchitis

16

What is based on the pathology, or the "anatomic alterations of the lung," associated with the disorder?

Emphysema

17

_____ is a preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.

COPD

18

What are some anatomic alterations of the lungs associated with chronic bronchitis?

Chronic inflammation, excessive mucus, mucus plugging, bronchospasm, hyperinflation/air trapping

19

What are some anatomic alterations of the lungs associated with emphysema?

Permanent enlargement, destruction of pulmonary capillaries, weakening of the distal airways, hyperinflation/air trapping

20

What are some considered risk factors for COPD?

Tobacco smoke, occupational dusts and chemicals, indoor/outdoor air pollution, conditions that affect normal lung grow and genetic predisposition (AAT deficiency)

21

What are the key indicators for considering a COPD diagnosis?

Dyspnea, chronic cough, chronic sputum production, history of exposure to risk factors

22

What are the 3 main spirometry tests for COPD?

FVC, FEV1, FEV1/FVC ratio

23

The presence of COPD is confirmed with both the ____ and ____ are decreased

FEV1; FEV1/FVC ratio

24

Stage I COPD

Mild; FEV1>=80%

25

Stage II COPD

Moderate; FEV1 50% to <80% of predicted and patient often complains of shortness of breath upon exertion

26

Stage III COPD

Severe; FEV1 30% to 50% impacts the quality of life

27

Stage IV COPD

Very severe; FEV1 <50% of predicted, plus chronic respiratory failure

28

Emphysema patients show a _____ body build and _____ where chronic bronchitis patients are ______.

Thin and barrel chest; stocky/overweight

29

Emphysema patients tend to have respiratory patterns like ________ where as chronic bronchitis patients tend to have respiratory patterns like _____

Hyperventilation; hypoventilation

30

Emphysema patients demonstrate ______ breathing while chronic bronchitis patients have a ____ and _____.

Pursed lip; cough and sputum

31

Emphysema patients have _____ skin while chronic bronchitis patients show signs of ______, ______ and _______.

Reddish; cyanosis, peripheral edema and neck vein distention

32

______ patients tend to use their accessory muscles when breathing

Emphysema

33

______ has decreased breath/heart sounds, prolonged expiration, decreased diaphragmatic excursion and hyperresonance while ______ has wheezes, crackles and rhonchi depending on the severity of the disease

Emphysema; chronic bronchitis

34

On a chest radiograph, _____ has hyperinflation, narrow mediastinum, normal or small vertical heart, low flat diaphragm and presence of blebs or bullae

Emphysema

35

On a chest radiograph, ____ has congested lung fields, densities, increased bronchial vascular markings, and an enlarged horizontal heart

Chronic bronchitis

36

Infections and polycythemia are commonly found in ____ patients

Chronic bronchitis

37

A decrease in DLco and DLco/VA is commonly found in ____ patients

Emphysema

38

What disease is associated with pulmonary hypertension and cor pulmonale?

Chronic bronchitis

39

Altered sensorium such as anxiety and irritability are often found in _____ patients

Emphysema (severe stage) and chronic bronchitis (moderate and severe stage)

40

Digital clubbing is often found in ____ patients

Late stage emphysema and chronic bronchitis

41

Hoover's sign is associated with what disease?

Emphysema (severe stage)

42

Upon palpation of the chest, decreased tactile fremitus, decreased chest expansion and PMI shifts to the epigastric area is often signs of what?

Emphysema

43

What is a normal ABG for a CO2 retained at equilibrium?

pH 7.38
SpO2 88-90
PaCO2 60
PaO2 58
HCO3 34

44

What are the ABG results for acute alveolar hyperinflation superimposed on chronic ventilatory failure?

pH 7.48
PaCO2 48
PaO2 38
HCO3 34

45

_____ is the dilation of the bronchi and bronchioles, which is chronic in nature and results in inflammation and damage to the walls of these airways

Bronchiectasis

46

What blood gas changes are associated with bronchiectasis?

Respiratory alkalosis with hypoxemia (acute alveolar hyperinflation) or in severe cases respiratory acidosis with hypoxemia (chronic alveolar hypoinflation)

47

_____ and ______ decrease in pulmonary function studies of bronchiectasis

Airflows and vital capacity

48

What feature favors the diagnosis of COPD?

Chronic daily phlegm production

49

Cough, phlegm production, wheezing and shortness of breath are common signs and symptoms of _____

COPD

50

What are the four clinical goals for managing stable COPD?

-Establish diagnosis
-Prolong survival
-Simplify medical regimen
-Optimize lung function
-Maximize patient's functional status

51

Both _____ and _____ bronchodilators can improve airflow in patients with COPD

Anticholinergic and adrenergic

52

Other treatment options to maximize lung function include administering _____ and methylxanthines

Corticosteroids

53

Systemic corticosteroids can produce significant improvements in airflow in _____ of patients with stable COPD

6%-29%

54

Controlled trials do show lessened dyspnea in _____ recipients despite lack of measurable increases in airflow

Methylxanthines

55

To minimize the chance of toxicity, current recommendations suggest maintaining serum theophylline levels at _____

8-10 mcg/ml

56

What can be done to prevent the progression of COPD?

Cessation of smoking

57

What therapy has been proven to prolong the survival of COPD patients?

Supplemental oxygen

58

PaO2 <= 55mmHg, PaO2 56-59mmHg or SaO2 89% signifies the need for _____

Continuous oxygen therapy

59

What are two surgeries that can be used in extreme cases for patient's with end stage COPD?

Lung transplantation or lung volume reduction surgery (LVRS)

60

Can all patients benefit from LVRS?

No, patients with severe COPD should not get it

61

___ of patients can be expected to live for five years after receiving a lung transplant surgery

54%