Chronic Obstructive Pulmonary Disease Flashcards
________ is a common respiratory condition
characterized by airflow limitation
Chronic obstructive pulmonary disease (COPD)
Establishing a correct diagnosis of COPD is important because….
appropriate management can decrease symptoms
reduce the frequency and severity of exacerbations
improve health status, improve exercise capacity, and prolong survival
Vast majority of COPD patients will have an hx of what
Smoking
_______ is a pathological term that describes some of the structural changes sometimes associated with COPD. These changes include abnormal and permanent enlargement of the airspaces distal to the terminal bronchioles that is accompanied by destruction of the airspace walls, without obvious fibrosis
Emphysema
“Pink Puffer” is _____ predominant
Emphysema
Patient presents with these issues what would you suspect?
- “Pink Puffer”
- Major complaint is dyspnea.
- over age 50
- Cough is rare, may have scant thin clear sputum
- Thin
- Uncomfortable appearing with accessory muscle use
- Chest is quiet without adventitious lung sounds
Emphysema
Patient presents with these issues what would you suspect?
- Blue Bloater
- Productive cough for three months at a time within 2 years
- Major c/o is productive chronic cough with mucopurulent sputum
- Frequent exacerbations due to chest infections
- mild dyspnea
- In their 30s and 40s
Chronic bronchitis
True/ False
Digital clubbing is typical in COPD
FALSE
Not typical
clubbing suggests other diagnoses such as lung cancer, bronchiectasis, pulmonary fibrosis
True/ False
Mild dependent edema may be seen in the absence of right heart failure
True
What can cause digital clubbing?
lung cancer, bronchiectasis, pulmonary fibrosis
What test is used to evaluate COPD
Spirometry
CXR for COPD might reveal what?
-nonspecific peribronchial and perivascular markings
(dirty lungs) seen with bronchitis predominant
-may show hyperinflation and flattening of the diaphragm in half the cases. (Emphysema)
Can you do Arterial Blood gasses for acute exacerbations on ship?
No they are obtained at higher levels of care that have capability
True/ False
Treatment is based on risk of exacerbation: COPD is largely preventable
True
What are Lifestyle modifications for treating COPD
1) STOP SMOKING
2) Elimination of exposure to products of combustion
3) Vaccination
4) Patient Education: use of inhaler
5) Nutrition and Self-Management
True/False
COPD is preventable, manageable and reversible
False
Irreversible damage is done
What is the 4th line agent for treating COPD who do not respond to inhaled anticholinergic, beta-2 agonists, and corticosteroid therapies?
Theophylline
What is commonly prescribed to COPD patients for the following?
a) Treat an acute exacerbation
b) Treat acute bronchitis
c) Prevent acute exacerbation of acute bronchitis
Antibiotics
True/False
Outlook is great for patients with significant disease. =]
False =[
Poor outlook
What action would you take:
If patient is stable, not in any acute distress, with normal vital signs and you suspect COPD in a patient with no previous COPD dx
consult with MO, referral for PFT’ s and pulmonology referral
What action would you take:
If patient is unstable, experiencing an acute exacerbation, has any acute distress or has any concerning abnormal vital signs,
discuss with MO and MEDEVAC
What action would you take:
Exacerbation is if there is SOB, dyspnea or a
lot of wheezing
add Oral Steroids in addition to the Albuterol
Prednisone
MOA for what med:
Selectively stimulates beta-2 adrenergic receptors, relaxing airway
smooth muscle
Short Acting Beta Antagonist
Albuterol
What is the confirmatory test for COPD
Spirometry
