Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Unit 2 Clin Med II > L10 COPD > Flashcards

L10 COPD Flashcards

(92 cards)

Start Studying
1
Q

small airway disease leads to

A

airway inflammation and remodeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

parenchymal destruction leads to

A

loss of alveolar attachments

decrease of elastic recoil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

thick, sticky mucus is more associated with

A

obstructive bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

air becoming trapped in damaged alveoli and air exchange becoming difficult is more associated with

A

emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

blue bloaters have

A

chronic bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

pink puffers have

A

emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

chronic bronchitis presents more with

A 
hypoxemia
respiratory acidosis
cor pulmonale from pulmonary hypertension
chronic bacterial colonization
airway hyper-reactivity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

chronic bronchitis is defined as

A

chronic productive cough for 3 or more months during 2 consecutive years with no other cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

structural changes that occur with chronic bronchitis

A

mucous gland enlargement causes hypersecretion
bronchial squamous metaplasia
loss of ciliary transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

inflammation in chronic bronchitis is mediated by

A

neutrophils

due to chronic bacterial colonization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

presents with inspiratory and expiratory obstruction

A

chronic bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

impeded ventilation in chronic bronchitis results in

A

hypoxemia

hypercapnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

has more parenchymal damage

A

emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

destruction of the alveolar walls in emphysema leads to

A

pathologic enlargement of the air spaces distal to the terminal bronchioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

2 possibilites for alveolar destruction in emphysema

A
  1. too much elastase

2. too little antitrypsin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

protease enzyme secreted by neutrophils and macrophages during inflammation, destroys bacteria and host tissues

A

neutrophil elastase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

inhibits neutrophil elastase

A

alpha-1 antitrypsin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

loss of alveolar supporting structure leads to

A

airway narrowing

compressed ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

presents with expiratory airflow obstruction

A

emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

when is hypoxemia present in emphysema

A

later in disease

destruction of capillary bed leads to reduced DLCO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

asthma is mediated by

A

eosinophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what cigarette smoking do

A

stimulates elastase

releases cytotoxic oxygen radicals from WBCs in lung tissye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

classic presentation of COPD

A

dyspnea
cough
sputum production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

most common symptom of COPD

A

dyspnea on exertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
physical exam findings of COPD
``` tripod positioning cyanosis tobacco staining of fingers JVD accessory muscle use pursed lip breathing ```
26
for some reason Ms. Shamblen seemed to really care about this finding
tobacco staining of fingers
27
how does pursed lip breathing help in emphysema
resistance to outflow raises intrabronchial pressure keeping the bronchi open longer to expel more air
28
lung findings in COPD
``` barrel chest (increased AP diameter) prolonged expiration increased resonance decreased breath sounds wheezing crackles at bases ```
29
heart findings in COPD
S3 gallop | RV lift
30
abdominal findings in COPD
hepatomegaly
31
extremities findings in COPD
muscle wasting | peripheral edema
32
cor pulmonale is
pulmonary hypertension resulting in impaired right ventricle dysfunction
33
what's unique about cor pulmonale
it's right ventricle dysfunction (hypertrophy, dilation) that ISN'T caused by left ventricle dysfunction
34
required for diagnosis of COPD
spirometry
35
why are other labs done with COPD if spirometry is the diagnostic measure
to rule out other causes o dyspnea and comorbid diseases
36
spirometry consistent with obstructive pattern
FEV1/FVC
37
other lung test findings with COPD
increased total lung capacity
38
severe emphysema will have
decreased diffusing capacity of carbon monoxide
39
why do you do a CBC
rule out anemia
40
seen on CBC of chronic bronchitis
polycythemia | secondary to chronic hypoxia
41
may be seen on CBC during acute exacerbations of CBC
leukocytosis
42
when to assess pulse ox (SpO2) further when | and with what
SpO2 <92% | arterial blood gas (PaO2)
43
PaO2 will probs show
mild/moderate hypoxemia without hypercapnia | severe disease: hypercapnia causing respiratory acidosis
44
when to obtain a sputum culture
in patient unresponsive to initial antibiotic treatment
45
what might be found on EKG
tachycardia right atrial enlargement right axis deviation and/or right ventricular hypertrophy
46
CXR will show
signs of air trapping (increased AP diameter, hyperinflation, hyperlucency, flat diaphragms) blebs or bullae
47
CXR of chronic bronchitis
cardiac enlargement pulmonary congestion +/- perivascular or peribronchial markings
48
pathognomonic for emphysema
blebs/bullae
49
CXR findings suggestive of emphysema
hyperinflation +/- bullae flattening of diaphragms enlargement of retrosternal air space
50
when to get a chest CT
symptoms suggest a complication of COPD (pneumonia, pneuomothorax, large bullae) rule out alternate diagnosis (PE)
51
when to get a high resolution CT
considering lung volume reduction surgery
52
what's the main goal of COPD management
prevent progression
53
group A tx
short acting bronchodilator -or- SABA + SAMA combo PRN
54
group B tx
long acting bronchodilator (LAMA or LABA)
55
group C tx
LAMA
56
group D tx
LABA + LAMA -or- consider ICS + LABA
57
albuterol is a
short acting beta agonist bronchodilator (SABA) | 2 puffs q4-6 hours
58
salmeterol is a
long acting beta agonist bronchodilators (LABA) | q12 hours
59
side effect of B2 agonists
``` ****** palpitations tachycardia insomnia tremors ****** ```
60
side effects of anticholinergic bronchodilators
dry mouth metallic taste headache cough
61
ipratropium bromide | irpatropium + albuterol
short acting anticholinergic (SAMA) | 2 puffs BID-QID
62
the BA in SABA/LABA is
beta agonist
63
the MA in SAMA/LAMA is
muscarinic antagonist (idk why they're called anticholinergics in the lecture just to make it more confusing)
64
tiotropium bromide
long acting anticholinergic (LAMA) | once daily
65
what are anticholinergics good at
reduce air trapping | less cardiac stimulation
66
whats the newest combo med for COPD tx
LAMA + LABA
67
theophylline is
a methylxanthine | old drugs for COPD, not used much due to side effects, toxicity, drug-drug interactions
68
when to use theophylline
refractory COPD
69
Umeclidinium
long acting anticholinergic (LAMA) | once daily
70
formoterol is a
long acting beta agonist bronchodilators (LABA) | q12 hours
71
advair
inhaled corticosteroid
72
dulera
inhaled corticosteroid
73
symbicort
inhaled corticosteroid
74
breo ellipta
inhaled corticosteroid
75
corticosteroids MOA
inhibit prostaglandins --> reduced mucosal edema/inflammation --> decreased secretions
76
corticosteroids side effects
**oral candidiasis** | bruising
77
alpha 1 antitrypsin deficiency is defined as
serum levels <11 uM
78
alpha 1 antitrypsin deficiency controversial tx
antiprotease replacement injections weekly/monthly
79
gold stage B-D should also get
pulmonary rehab
80
give O2 when to reach the goal of for how long
chronic dyspnea at rest SpO2 > 90% all the time 12+ hours a day
81
caution with O2 therapy | how to prevent it
high flow O2 may reduce drive to breath, causing respiratory acidosis maintain O2 90-92%
82
educate COPD pts to
***recognize early signs of pulmonary infection***
83
early signs of pulmonary infection
``` increased sputum production fever worsening dyspnea chest pain hemoptysis ```
84
what is increased dyspnea increased cough frequency/severity increased or purulent sputum
acute exacerbation of COPD
85
acute exacerbation of COPD is triggered by
``` respiratory illnesses (usually VIRAL) pollution ```
86
viral triggers of acute exacerbation of COPD
rhinovirus influenza may lead to secondary bacterial pneumonia
87
most common bacterial pathogens in acute exacerbation of COPD/secondary bacterial pneumonia (unclear which she meant)
``` H influenzae S pneumoniae Moraxella cararrhalis Mycoplasma pneumoniae Pseudomonas aeruginosa ```
88
starred bacterial pathogen
***pseudomonas aeruginosa***
89
treatment of acute exacerbation of COPD
``` increase dose of SABA can add ipratropium to regimen Oral steroids (40 mg/day x 5 days) ```
90
treatment of moderate/severe acute exacerbation of COPD
antibiotics: ***Macrolide (azithromycin, clarithromycin) Fluoroquinolone (moxifloxacin, gemifloxacin, levofloxacin)***
91
treatment of severe acute exacerbation of COPD
hospitalization
92
indications to hospitalize
``` severe signs/symptoms severe underlying COPD (FEV1 <50%) significant comorbities onset of new physical symptoms (cyanosis, edema, arrhythmias) failure to respond to initial meds older age insufficient home support ```

Unit 2 Clin Med II (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions