Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory > COPD > Flashcards

COPD Flashcards

1
Q

What is COPD?

A

Non-reversible, long term deterioration in air flow through the lungs caused by damage to lung tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two forms of COPD?

A
  • Chronic bronchitis
  • Emphysema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the damage to the lung tissue result in?

A

An obstruction to the flow of air through the airways making it more difficult to ventilate the lungs and making them prone to developing infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the main cause of COPD?

A

Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the typical presentation of COPD?

A
  • cough: often productive
  • dyspnoea
  • wheeze
  • Long term history of smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the main investigations for COPD?

A

Full blood count
BMI
Spirometry
Chest X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What would you look for in a full blood of someone with suspected COPD?

A

Polycythaemia (too many RBC) or anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does polycythaemia a response to?

A

Chronic hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What might you see on a chest x-ray of someone with COPD?

A
  • hyperinflation
  • bullae
  • flat hemidiaphragm
  • lack of lung markings
  • large central pulmonary arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What would postbronchodilator spirometry be in someone with COPD?

A

FEV1:FVC <70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the diagnosis of COPD based on?

A

Clinical history and spirometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the severity of COPD based of?

A

FEV1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is stage 1 COPD?

A

FEV1 >80% predicted
Mild symptoms of COPD present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is stage 2 COPD?

A

FEV1 50-79% predicted
Moderate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is stage 3 COPD?

A

FEV1 30-49% predicted
Severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is stage 4 COPD?

A

FEV1 <30% predicted
Very severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the general management of COPD?

A

smoking cessation advice
annual influenza vaccination
one-off pneumococcal vaccination
pulmonary rehabilitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the first line management of COPD?

A

Bronchodilator therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the first line bronchodilators?

A
  • short-acting beta2-agonist (SABA) or
  • short-acting muscarinic antagonist (SAMA)-
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are examples of SABA inhalers?

A

Salbutamol
Terbutaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are examples of SAMA inhalers?

A

Ipratropium bromide

22
Q

For patients who remain breathless or have exacerbations despite using short-acting bronchodilators, what is the next step dependent on?

A

Asthmatic features/features suggesting steroid responsiveness
No asthmatic features/features suggesting steroid responsiveness

23
Q

What is the next step in the management of a patient with NO asthmatic features/features suggesting steroid responsiveness?

A

Add a long-acting beta2-agonist (LABA) + long-acting muscarinic antagonist (LAMA

24
Q

What is the next step in the management of a patient with asthmatic features/features suggesting steroid responsiveness?

A

LABA + inhaled corticosteroid (ICS)

25
Q

What is the management of a patient if they remain breathless or have exacerbations?

A

Offer triple therapy

26
Q

What is triple therapy?

A

LAMA + LABA + ICS

27
Q

What should you switch a SAMA to when adding a LAMA/LABA?

A

Switch to a SABA

28
Q

When should oral theophylline be tried for someone with COPD?

A

Only after trying short and long-acting bronchodilators or for those who cannot used inhaled therapy

29
Q

What oral antibiotic prophylactics could you give to someone with COPD?

A

Azithromycin

30
Q

When might mucolytics be considered in a patient with COPD?

A

In patients with a chronic productive cough

31
Q

When might long term oxygen therapy be considered?

A
  • very severe airflow obstruction
  • cyanosis
  • polycythaemia
  • peripheral oedema
  • raised jugular venous pressure
  • oxygen saturations less than or equal to 92% on room air
32
Q

What level of airflow obstruction would indicate long term oxygen therapy?

A

FEV1 < 30% predicted

33
Q

Who should long term oxygen therapy not be offered to?

A

people who smoke

34
Q

What is emphysema?

A

Abnormal irreversible enlargement of the airspaces distal to the terminal bronchioles
Reduces the alveolar surface area thus impeding efficient gaseous exchange.

35
Q

What is chronic bronchitis?

A

Chronic exposure to noxious particles causes hypersecretion of mucus in the large and small bronchi.
Airway inflammation and fibrotic changes result in narrowing of the airways and subsequently chronic airway obstruction.

36
Q

What would suggest asthmatic features that would respond to steroids?

A

PMH of atopy or asthma
Eosinophilia
substantial variation in FEV1 over time (at least 400 ml)
Substantial diurnal variation in peak expiratory flow (20%)

37
Q

What is the main cause of chronic bronchitis?

A

Smoking

38
Q

What are the possible causes of emphysema?

A

Smoking
Alpha-1 antitrypsin

39
Q

What are the requirements for long term antibiotic prophylaxis for COPD?

A

Patients should not smoke
Should have optimised standard treatments and continue to have exacerbations

40
Q

What needs to be done before azaithromycin can be prescribed?

A

ECG to exclude QT prolongation should also be done as azithromycin can prolong the QT interval

41
Q

What does a deficienct of Serum alpha-1 antitrypsin deficiency lead to?

A

Early onset and more severe disease

42
Q

What would you find on -Pulse oximetry and ABG/VBG of someone with COPD?

A

↓PaCO2, hypercapnia

43
Q

What is hypercapnia?

A

Presence of higher than normal level of carbon dioxide in the blood

44
Q

What would you see on a CT thorax of someone with COPD?

A

Bronchial wall thickening
Scarring

45
Q

What will the post-bronchodilator spirometry always stay at in someone with COPD?

A

It will always be <0.7

46
Q

What might you see on an ECG and echo of someone with COPD?

A

Right atrial and ventricular hypertrophy

47
Q

Why would you do a sputum culture in someone with COPD?

A

To check for infection

48
Q

What are the features of Cor pulmonale in COPD?

A

Peripheral oedema
Raised jugular venous pressure
Systolic parasternal heave
Loud P2

49
Q

What can be used in the management of cor pulmonale in COPD?

A

Loop diuretic for oedema, Consider long-term oxygen therapy

50
Q

What can be used to improve surivival in someone with COPD?

A

smoking cessation
long term oxygen therapy
lung volume reduction surgery

51
Q

When would LTOT be offered for someone with COPD?

A

2 result of pH <7.3
or
Those with a pO2 of 7.3 - 8 kPa and one of the following:
–secondary polycythaemia
–peripheral oedema
–pulmonary hypertension

Respiratory (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions