adult obstructive lung disease

Question 1

what is the most common chronic disease in 1st world countries?

Answer 1

asthma

Question 2

who has the worst outcome for asthma?

Answer 2

young af am males

Question 3

pathogenesis of asthma

Answer 3

inflammation + cellular inffiltration

Question 4

major inflammatory mediators of asthma

Answer 4

histamine, leukotrienes, kallikrein, platelet activation factor

Question 5

positive bronchodilator test for asthma: Requires > ____% increase in FEV1 as well as at least a ____ ml increase or increases in the FVC or FEF25-75

Answer 5

Requires > 12% increase in FEV1 as well as at least a 200 ml increase or increases in the FVC or FEF25-75

Question 6

how to use long acting beta agonists in tx of asthma?

Answer 6

NEVER as monotx

Question 7

which drug used to tx asthma has a small therapeutic window?

Answer 7

theophylline

Question 8

does asthma or COPD involve airflow limitation that is reversible?

Answer 8

asthma

Question 9

cough occurs every day with sputum production that lasts for at least 3 months, 2 years in a row

Answer 9

chronic bronchitis

Question 10

what results in airway limitation in COPD (2) ?

Answer 10

1. small airway disease

2. parenchymal disease

Question 11

Abnormal and permanent enlargement of the airspaces distal to the terminal bronchioles and accompanied by destruction of the airspace walls.

Answer 11

emphysema

Question 12

FEV1/FVC less than 0.7 indicates?

Answer 12

obstructive lung disease

Question 13

what do you use to determine severity of COPD?

Answer 13

post bronchodilator FEV1

Question 14

what % post bronchodilator FEV1 dictates severe COPD

Answer 14

under 50%

Question 15

how to assess risk of exacerbtations of COPD?

Answer 15

1. h/o exacerbations 2. spirometry

Question 16

high risk of COPD exacerbations: ____exacerbations within last year or an FEV ______

Answer 16

2+ exacerbations within last year or an FEV under 50%

Question 17

continuous inflammation of airway, chronic productive cough typically w/ large amts of sputum

Answer 17

bronchiectasis

Question 18

what is the single most important intervention to prevent COPD and slow progression of disease?

Answer 18

tobacco smoking cessation

Question 19

what medications cure COPD?

Answer 19

NONE, but can modify long term decline in lung fxn

Question 20

which vaccinations should a person w/ COPD be provided?

Answer 20

influenza, pneumococcal

Question 21

in management of COPD exacerbations, who should be tx’d with antibiotics?

Answer 21

those with the 3 cardinal sx or who require mechanical ventilation

Question 22

what are the 3 cardinal sx that dictate antibiotic usage in management of COPD exacerbations

Answer 22

increased dyspnea, increased sputum volume, and increased sputum purulence