13 - COPD

Question 1

definition of emphysema

Answer 1

airspaces distal to terminal bronchioles are enlarged w/ destruction of alveolar walls

Question 2

genetic risk factor for COPD and how it contributes

Answer 2

alpha 1 anti-trypsin deficiency (AR)

AAT is a protease inhibitor that protects lungs from proteolytic attack during inflammation

Question 3

pathogenesis of COPD in large airways

Answer 3

squamous metaplasia - impaired mucociliary clearance
mucous gland enlargement
large airway goblet cell hyperplasia

Question 4

3 main pathophys results of COPD

Answer 4

airflow obstruction
hyperinflation
impaired gas exchange

Question 5

comorbidities of COPD

Answer 5

lung CA
pulm HTN
anemia
diabetes
anxiety/depression
CV dz
peripheral muscle wasting/dysfuction (cachexia)
osteoporosis
peptic ulcers

Question 6

one of the few medical interventions proven to reduce mortality in COPD

Answer 6

oxygen therapy

Question 7

stages of pharm management of COPD

Answer 7

a - short acting bronchodilator prn
b - add long acting bronchodilator and pulm rehab
c - add inhaled corticosteroid (never monotherapy in COPD)
d - consider PDE4 inhib

Question 8

tx of COPD exacerbation

Answer 8

aggressive bronchodilators
abx
systemic corticosteroids
O2 if needed
mech ventilation (non invasive if enough)