3.2 DX and TX of Asthma and COPD Flashcards
What are 3 pathophysiological mechanisms for wheezing?
Bronchial hyper-responsiveness (bronchoconstriction), Inflammation of the airways, Mucours hypersecretion
Associate CD4 and CD8 with COPD or Asthma
Asthma: CD4 as COPD: CD8
Give key differences between asthma and COPD
Asthma: reversible airflow limitation, onset early in life, sx vary day to day
COPD: irreversible airflow limitation, onset mid-life, sx slowly progressive
What characterizes a positive bronchodilator response?
FVC or FEV improves by 12%. Requires atleast 200cc to improve in FEV1 or FVC
What is a good way of managing moderate to severe asthma?
taking peak expiratory flow measurements every morning, evening, after an exacerbation and before inhaling certain medications
Differentiate pink puffers from blue bloaters
Pink puffers: acyanotic, no bronchitic component, dyspnea early
Blue bloaters: cyanotic, bronchitic component, dyspnea late
What is obstructive lung disease characterized by?
decrease in expiratory flow rates: FEV1, FVC (can be normal), FEV1/FVC, increased TLC, increased RV, decreased DLCO, scooped on flow vol curve
What value should FEV1/FVC be below to dx COPD?
it should be less than 0.70
What are 2 goals of therapy to reduce sx?
improve exercise tolerance and health status
What are 3 goals of therapy to reduce risk?
prevent disease progression, prevent and treat exacerbations, reduce mortality
What is the target saturation of O2 therapy?
88-92%
Define exacerbation
acute event that worsens pts resp sx beyon normal day to day variations and leads to a change in meds. These can often be prevented
Whats the standard corticosteroid tx
40mg prednisone for 5 days
What are the three cardinal sx that require antibiotic tx?
increased dyspnea, increased sputum vol., increased sputum purulence.
