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Pulmonology > 286 COPD > Flashcards

286 COPD Flashcards

1
Q

Major risk factor for mortality in COPD

A

Cigarette

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2
Q

Most significant predictor of FEV1

A

Cigarette smoking

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3
Q

Leads to exacerbation

A

Respiratory infection

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4
Q

True or false. Ambient air pollution is a risk factor for COPD

A

False. Not proven yet. But can trigger exacerbation

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5
Q

Spectrum of COPD

A

Pink puffer: emphysema dominant

Blue bloater: bronchitis dominant

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6
Q

Reasons for cachexia in COPD

A

Inadequate intake and elevated level of TNF alpha

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7
Q

Pulmonary test result in COPD

A

FEV1 dec
FEV/FVC dec
Lung volume RV inc
DLCO (emphysema) dec

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8
Q

Classification of COPD based on severity

A

GOLD 1 FEV1 more than 80
GOLD 2 less than 80
GOLD 3 50
GOLD 4 less than 30

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9
Q

Therapy proven to improve survival in COPD

A

Smoking cessation
Oxygen therapy
Lung reduction surgery

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10
Q

Nicotine replacement used in COPD

A

Bupropion

Varenicline

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11
Q

Primary treatment for almost all patients with COPD

A

Bronchodilators

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12
Q

Common side effect of anticholinergic muscarinic antagonist

A

Dry mouth

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13
Q

Acute improvement in lung function

A

SABA

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14
Q

For symptomatic relief in long term and reduce exacerbations

A

LABA

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15
Q

Side effects of beta agonist

A

Tremors and tachycardia

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16
Q

Main role of inhaled corticosteroids

A

Reduce exacerbations

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17
Q

Side effects of inhaled corticosteroids

A

Oropharyngeal candidiasis

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18
Q

Side effects of oral glucocorticoids

A

Osteoporosis

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19
Q

Only pharmacologic therapy shown to decrease mortality rate

A

Oxygen therapy

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20
Q

True or false. COPD is the second leading indication for lung transplantation

A

True.

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21
Q

Strongest single predictor of COPD exacerbation

A

Previous exacerbation

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22
Q

Defined as acute worsening of respiratory symptoms

A

Exacerbation

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23
Q

True or false. PFT is not helpful during exacerbation in COPD compared to asthma

A

True

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24
Q

Potential indications of hospitalization for COPD

A

Acute respiratory failure

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25
Q

Treatment in COPD exacerbation

A

Bronchodilators
Systemic glucocorticoids
Antibiotics
Supplemental O2

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26
Q

Common pathogen leading to exacerbation in COPD

A

Strep pneumo
H influenza
M. Catarrhalis

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27
Q

Volume of air exhaled within the first second of forced expiration

A

FEV1

28
Q

Total volume of air exhaled during the entire maneuver

A

FVC

29
Q

Treatment for Group A

A

SABA

30
Q

True or false. Mortality benefit equals number of hours per day on oxygen

A

True

31
Q

True or false. Influenza vaccine yearly can reduce serious illness and death in COPD

A

True

32
Q

True or false. PPSV23 reduced incidence of CAP in COPD less than 65 years old

A

True

33
Q

True or false. PCV13 reduces bacteraemia and invasive pneumococcal disease more than 65 years old

A

True.

34
Q

True or false. ICS is withdrawn in stable patient

A

True

35
Q

Goals of therapy of COPD

A 
Provide symptomatic relief
Reduce further risk
- prevent disease progression
- prevent and treat exacerbation
- reduce mortality
36
Q

defined as a disease state characterized by persistent respiratory symptoms and airflow limitation that is not fully reversible

A

Chronic obstructive pulmonary disease

37
Q

Anatomically defined condition characterized by destruction of the lung alveoli with air space enlargement

A

emphysema

38
Q

clinically defined condition with chronic cough and phlegm

A

chronic bronchitis

39
Q

what makes up COPD

A

emphysema, chronic bronchitis and small airway disease

40
Q

condition in which small bronchioles are narrowed and reduced in number

A

small airway disease

41
Q

a major physiologic change in COPD that can result in small airway disease and or emphysema

A

airflow limitation

42
Q

hallmark of advanced COPD

A

fibrosis, and extensive small airway destruction

43
Q

remains a prevailing mechanism for the development of emphysema

A

elastase:antielastase hypothesis

44
Q

key component of COPD pathobiology

A

Oxidative stress

45
Q

major regulator of oxidant-antioxidant balance in COPD

A

NRF2

46
Q

potent antioxidant, have been implicated in emphysema pathogenesis

A

SOD3

47
Q

True or false. Mitochondrial dysfunction in COPD may worsen oxidative stress

A

True.

48
Q

subjects at greatest risk of progression in COPD

A

those with both aggressive airway disease and emphysema

49
Q

Gold Stage I. What is the spirometry

A

FEV1 more than 80

50
Q

Gold Stage II. What is the spirometry

A

FEV1 more than 50

51
Q

Gold Stage III. What is the spirometry

A

FEV1 more than 30

52
Q

Gold Stage IV. What is the spirometry

A

FEV1 less than 30

53
Q

major site of increased resistance in most individuals with COPD

A

airways ≤2 mm diameter

54
Q

distinct pathologic types of emphysema

A

centrilobular,panlobular, paraseptal

55
Q

most frequent type of emphysema associated with cigarette smoking

A

centrilobular

56
Q

type of emphysema most prominent in the upper lobes and superior segments of lower lobes and is often quite focal

A

centrilobular

57
Q

emphysema characterized as abnormally large air spaces evenly distributed within and across acinar units panlobular

A

panlobular

58
Q

Panlobular emphysema is commonly observed in patients with

A

α1AT deficiency

59
Q

type of emphysema that occurs in 10–15% of cases and is distributed along the pleural margins with relative sparing of the lung core or central regions

A

paraseptal

60
Q

most typical finding in COPD

A

Persistent reduction in forced expiratory flow rates

61
Q

accounts for essentially all of the reduction in Pao2 that occurs in COPD;

A

Ventilation-perfusion mismatching

62
Q

major risk factor for mortality from chronic bronchitis and emphysema.

A

cigarette smoking

63
Q

most highly significant predictor of FEV1

A

Pack-years of cigarette smoking

64
Q

allele is associated with normal α1AT levels

A

M allele

65
Q

associated with slightly reduced α1AT levels

A

S allele

66
Q

associated with markedly reduced α1AT levels,

A

Z allele

67
Q

Percent COPD patients are found to have severe α1AT deficiency

A

1.00%

Pulmonology (9 decks)

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