Chronic Pulmonary Disease

Question 1

what diseases are included in COPD

Answer 1

emphysema
chronic bronchitis

Question 2

what occurs in emphysema?

Answer 2

impaired gas exchange causes distended alveoli
increased dead space causes hypoxemia and hypercapnia

Question 3

what occurs in chronic bronchitis?

Answer 3

inflammation and hypersecretion of mucus
bronchial walls thicken
fibrosis of alveoli
increased risk for respiratory infections

Question 4

COPD risk factors

Answer 4

smoking - present in 80-90% of COPD cases
secondhand smoke
old age
occupational exposure to dust/chemicals
pollution
genetics

Question 5

what are the 3 primary symptoms of COPD?

Answer 5

chronic cough
sputum production
dyspnea

Question 6

what are the additional symptoms of COPD?

Answer 6

Barrel chest
accessory muscle use, tripod position
weight loss
wasting
depression
wheezing
fatigue

Question 7

what is Cor Pulmonnale?

Answer 7

hypoxemia causes increased pulmonary artery pressure
this causes right sided heart failure because of increased workload on right ventricle

Question 8

signs and symptoms of right sided HF

Answer 8

JVD
hepatosplenomegaly
pitting edema
ascites
anorexia and weight gain
fatigue

Question 9

meds for smoking cessation

Answer 9

nicotine gum, lozenges
bupropion
chantix

Question 10

oxygen therapy for COPD

Answer 10

SpO2 goal is >90%
PaO2 goal is > 60
use least amount of O2 possible to achieve goal to avoid oxygen toxicity

Question 11

COPD medications

Answer 11

bronchodilators - improve expiratory flow
inhaled or oral corticosteroids - not for long-term use
antibiotics for infectious exacerbation