286 COPD

Question 1

Major risk factor for mortality in COPD

Answer 1

Cigarette

Question 2

Most significant predictor of FEV1

Answer 2

Cigarette smoking

Question 3

Leads to exacerbation

Answer 3

Respiratory infection

Question 4

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

Answer 4

False. Not proven yet. But can trigger exacerbation

Question 5

Spectrum of COPD

Answer 5

Pink puffer: emphysema dominant

Blue bloater: bronchitis dominant

Question 6

Reasons for cachexia in COPD

Answer 6

Inadequate intake and elevated level of TNF alpha

Question 7

Pulmonary test result in COPD

Answer 7

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

Question 8

Classification of COPD based on severity

Answer 8

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

Question 9

Therapy proven to improve survival in COPD

Answer 9

Smoking cessation
Oxygen therapy
Lung reduction surgery

Question 10

Nicotine replacement used in COPD

Answer 10

Bupropion

Varenicline

Question 11

Primary treatment for almost all patients with COPD

Answer 11

Bronchodilators

Question 12

Common side effect of anticholinergic muscarinic antagonist

Answer 12

Dry mouth

Question 13

Acute improvement in lung function

Answer 13

SABA

Question 14

For symptomatic relief in long term and reduce exacerbations

Answer 14

LABA

Question 15

Side effects of beta agonist

Answer 15

Tremors and tachycardia

Question 16

Main role of inhaled corticosteroids

Answer 16

Reduce exacerbations

Question 17

Side effects of inhaled corticosteroids

Answer 17

Oropharyngeal candidiasis

Question 18

Side effects of oral glucocorticoids

Answer 18

Osteoporosis

Question 19

Only pharmacologic therapy shown to decrease mortality rate

Answer 19

Oxygen therapy

Question 20

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

Answer 20

True.

Question 21

Strongest single predictor of COPD exacerbation

Answer 21

Previous exacerbation

Question 22

Defined as acute worsening of respiratory symptoms

Answer 22

Exacerbation

Question 23

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

Answer 23

True

Question 24

Potential indications of hospitalization for COPD

Answer 24

Acute respiratory failure

Question 25

Treatment in COPD exacerbation

Answer 25

Bronchodilators Systemic glucocorticoids Antibiotics Supplemental O2

Question 26

Common pathogen leading to exacerbation in COPD

Answer 26

Strep pneumo H influenza M. Catarrhalis

Question 27

Volume of air exhaled within the first second of forced expiration

Answer 27

FEV1

Question 28

Total volume of air exhaled during the entire maneuver

Answer 28

FVC

Question 29

Treatment for Group A

Answer 29

SABA

Question 30

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

Answer 30

True

Question 31

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

Answer 31

True

Question 32

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

Answer 32

True

Question 33

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

Answer 33

True.

Question 34

True or false. ICS is withdrawn in stable patient

Answer 34

True

Question 35

Goals of therapy of COPD

Answer 35

``` Provide symptomatic relief Reduce further risk - prevent disease progression - prevent and treat exacerbation - reduce mortality ```

Question 36

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

Answer 36

Chronic obstructive pulmonary disease

Question 37

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

Answer 37

emphysema

Question 38

clinically defined condition with chronic cough and phlegm

Answer 38

chronic bronchitis

Question 39

what makes up COPD

Answer 39

emphysema, chronic bronchitis and small airway disease

Question 40

condition in which small bronchioles are narrowed and reduced in number

Answer 40

small airway disease

Question 41

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

Answer 41

airflow limitation

Question 42

hallmark of advanced COPD

Answer 42

fibrosis, and extensive small airway destruction

Question 43

remains a prevailing mechanism for the development of emphysema

Answer 43

elastase:antielastase hypothesis

Question 44

key component of COPD pathobiology

Answer 44

Oxidative stress

Question 45

major regulator of oxidant-antioxidant balance in COPD

Answer 45

NRF2

Question 46

potent antioxidant, have been implicated in emphysema pathogenesis

Answer 46

SOD3

Question 47

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

Answer 47

True.

Question 48

subjects at greatest risk of progression in COPD

Answer 48

those with both aggressive airway disease and emphysema

Question 49

Gold Stage I. What is the spirometry

Answer 49

FEV1 more than 80

Question 50

Gold Stage II. What is the spirometry

Answer 50

FEV1 more than 50

Question 51

Gold Stage III. What is the spirometry

Answer 51

FEV1 more than 30

Question 52

Gold Stage IV. What is the spirometry

Answer 52

FEV1 less than 30

Question 53

major site of increased resistance in most individuals with COPD

Answer 53

airways ≤2 mm diameter

Question 54

distinct pathologic types of emphysema

Answer 54

centrilobular,panlobular, paraseptal

Question 55

most frequent type of emphysema associated with cigarette smoking

Answer 55

centrilobular

Question 56

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

Answer 56

centrilobular

Question 57

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

Answer 57

panlobular

Question 58

Panlobular emphysema is commonly observed in patients with

Answer 58

α1AT deficiency

Question 59

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

Answer 59

paraseptal

Question 60

most typical finding in COPD

Answer 60

Persistent reduction in forced expiratory flow rates

Question 61

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

Answer 61

Ventilation-perfusion mismatching

Question 62

major risk factor for mortality from chronic bronchitis and emphysema.

Answer 62

cigarette smoking

Question 63

most highly significant predictor of FEV1

Answer 63

Pack-years of cigarette smoking

Question 64

allele is associated with normal α1AT levels

Answer 64

M allele

Question 65

associated with slightly reduced α1AT levels

Answer 65

S allele

Question 66

associated with markedly reduced α1AT levels,

Answer 66

Z allele

Question 67

Percent COPD patients are found to have severe α1AT deficiency

Answer 67

1.00%