Lecture 12 COPD Flashcards Preview

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Flashcards in Lecture 12 COPD Deck (36):
1

COPD:
____ decreases dramatically;
FVC _____;
What happens to the ratio?

FEV1; decreases;
Ratio decreases

2

Is COPD due to obstruction of inflow or obstruction of outflow?

outflow

3

Bronchitis vs Emphysema:
patients are overweight and cyanotic =
patients are older and thin =
Peripheral edema is common =
Increased AP diameter of chest =

bronchitis (blue bloater);
emphysema (pink puffer);
bronchitis;
emphysema

4

COPD:
____ lose their shape and become clogged with mucus;
walls of ____ are destroyed.

bronchioles;
alveoli

5

bronchitis vs emphysema:
enlargement of air spaces =
loss of elastic recoil =
hyperplasia of mucus secreting glands =
barrel shaped chest =

emph;
emph;
bronch;
emph

6

90% of patients with COPD are ____

smokers

7

what is required to establish diagnosis of COPD?

spirometry

8

What spirometric finding tells you how severe the COPD is?

FEV1; ie more decreased FEV1 = more severe disease

9

COPD vs asthma:
which is reversible?
persistent and productive cough seen in =

asthma;
COPD

10

what genetic deficiency should be screened for in patients with COPD of a young age?

alpha 1 antitrypsin

11

CXR of patient with COPD shows a ____ diaphragm

flattened

12

most important therapeutic option in treating COPD

smoking cessation

13

2 autonomic drugs used in treatment of COPD

beta 2 agonists, anticholinergics

14

____ corticosteroids are used in short term inhalers. ____ corticosteroids are used during periods of COPD exacerbation.

inhaled;
systemic

15

_____ inhibitors are specifically used in bronchitis patients

phosphodiesterase-4

16

what treatment is recommended at all stages of COPD?

exercise rehab

17

exercise rehab helps with improvements in _____ tolerance and symptoms of ____ and ____

exercise; dyspnea, fatigue

e.g. breaks the "spiral of disability/deconditioning"

18

what COPD treatment has been shown to increase survival in patients with severe, resting hypoxemia?

oxygen therapy (at least 15 hours a day)

19

non-invasive ventilatory support should be used in patients with pronounced day-time _____

hypercapnia (ie increased CO2)

20

Lung volume reduction surgery (LVRS) is more efficacious in patients with ____-lobe _____ and low _____ capacity

upper, emphysema;
exercise

21

what is indicated in patients with a PaO2 less than 55 and a SaO2 less than 88%?

long term oxygen therapy

22

what is "P" pulmonale?

tall peaked P waves;
indicates R. atrial enlargement

23

most common cause of exacerbation of COPD?

infection.

also edema, PE, pneumothorax, non-compliance

24

in patients with COPD exacerbation, ____, ____, or bleeding may be present on whole blood count

anemia, polycythemia (due to decreased O2)

25

what kind of test is not recommended during COPD exacerbation?

spirometric

26

What is the target saturation of oxygen for treatment of patients with COPD exacerbation? Why not higher?

88-92;
want to avoid CO2 narcosis

27

3 cardinal symptoms of bacterial COPD exacerbation (anthonisen criteria):

increased dyspnea, increased sputum volume, increased sputum purulence

antibiotics should be given

28

2 other indicators that antiobiotics should be given to a patient with COPD exacerbation:

mechanical ventilation; CXR indicative of pneumonia

29

nicotine is _____ but does not cause _____

addictive, lung damage

30

by ____ years after quitting smoking, all cause mortality falls to levels of a never-smoker

15

31

5 A's approach to talking about quitting smoking with a patient

ask, assess, advise, assist, arrange

32

2 prescription medicines approved for cessation of tobacco usage

bupropion, varenicline

33

besides prescription meds, what is the other general type of pharmacotherapy?

nicotine-replacement therapy ie patch or gum

34

mechanism of action of bupropion

NE and dopamine reuptake inhibitor

35

mechanism of action of varenicline

nicotine receptor partial agonist

36

do anticholinergics work better in treatment of asthma or COPD?

COPD (not v effective in asthma)