42. COPD Flashcards
COPD is most commonly caused by ___ =, but can be caused by other air pollutants
tobacco smoke
____ is the destruction of the small passages in the lungs (alveoli)
Emphysema
____ is the inflammation and narrowing of the bronchial tubes (results in mucus production and chronic cough)
Bronchitis
Pts with ____ deficiency are at a higher risk of developing COPD
Alpha-1 antitrypsin (AAT)
Note: AAT helps protect lungs from damage caused by inflammation
T/F: In COPD, the limitation of airflow is fully reversible with treatment
False - not fully reversible and progresses over time, leading to gradual loss of lung function
A post-bronchodilator FEV1/FBC < ____ confirms a dx of COPD
0.70
Which guidelines are used for COPD treatment?
GOLD
Predicted FEV1 for GOLD 1 (Mild) COPD
FEV1 ≥ 80%
Predicted FEV1 for GOLD 2 (Moderate) COPD
50% ≤ FEV1 < 80%
Predicted FEV1 for GOLD 3 (Severe) COPD
30% ≤ FEV1 < 50%
Predicted FEV1 for GOLD 4 (Very Severe) COPD
FEV1 < 30%
What are the two most commonly used symptom assessment scoring systems?
Modified British Medical Research Council (mMRC) dyspnea scale
COPD Assessment Test (CAT)
mMRC dyspnea scale assesses _____ whereas the CAT is a ___
breathlessness
comprehensive assessment of symptoms (e.g. cough, mucus, production, chest tightness, energy level, breathlessness, sleep patterns, limitations to normal activity)
Define COPD exacerbation
Increase in respiratory symptoms that worsen over < 14 days
Hospitalization for COPD exacerbation is a/w increased risk of ___
death
If a patient has __ or more exacerbations per year, they are considered to be frequent exacerbators
2 or more
Define COPD group A:
CAT score ___
mMRC score ____
Exacerbations ____
CAT <10
mMRC 0-1
0-1 moderate exacerbations (no hospitalization)
Define COPD group B:
CAT score ___
mMRC score ____
Exacerbations ___
CAT ≥10
mMRC ≥ 2
0-1 moderate exacerbations (no hospitalization)
Define COPD group E:
CAT score ___
mMRC score ____
Exacerbations ___
≥ 2 moderate exacerbations or ≥ 1 hospitalization d/t exacerbations
regardless of CAT/mMRC scores
Vaccine recommendation for COPD pts
Annual influenza, pneumococcal vaccines and Tdap
___ is the only non-drug management strategy proven to slow progression of COPD
Smoking cessation
____ are first-line treatment for all COPD pts
Bronchodilators
ICS are recommended in select pts with hx of exacerbations and eosinophil counts (marker of inflammation) ≥ _____ cells/µL
≥300
Note: not recommended in pts with lower eosinophil counts (<100), no demonstrated benefit
Initial pharmacologic therapy for COPD: Group A
Bronchodilator (SAMA prn, SABA prn, LAMA or LABA)
