COPD Flashcards by John Fasulo

What 3 disease states make up COPD?

Chronic Bronchitis, Emphysema, Asthma

How well did you know this?

Not at all

Perfectly

COPD can be divided into what two disease pathology?

Obstructive & Restrictive

How well did you know this?

Not at all

Perfectly

What is the primary metric for diagnosis for Obstructive Disease?

How well did you know this?

Not at all

Perfectly

What are some examples of Obstructive Disease?

How well did you know this?

Not at all

Perfectly

What are the primary 2 symptoms displayed by patients with of Obstructive Disease?

Dyspnea & Trouble Exhaling

How well did you know this?

Not at all

Perfectly

What is the diagnoses for Restrictive Disease?

How well did you know this?

Not at all

Perfectly

What are some metrics of Restrictive Disease?

How well did you know this?

Not at all

Perfectly

What is the primary symptom(s) of Restrictive Disease?

Dyspnea & Coughing

How well did you know this?

Not at all

Perfectly

FEV1 (Forced Expiratory Volume in 1 sec) = what?

The amount of air exhaled during the 1st sec of FVC

How well did you know this?

Not at all

Perfectly

What is a healthy FEV1%?

> 70%

How well did you know this?

Not at all

Perfectly

What are some metrics associated with obstructive disorders?

FEV1 Reduced
FVC Normal
FEV1/FVC Ratio Reduced

How well did you know this?

Not at all

Perfectly

What are some metrics of restrictive disorders?

FEV1 and FVC Reduced
FEV1/FVC Ratio Normal or Increased

How well did you know this?

Not at all

Perfectly

How is COPD characterized?

Characterized by the presence of airflow obstruction attributable to either chronic bronchitis or emphysema.

How well did you know this?

Not at all

Perfectly

Does COPD have a cure?

Progressive Disease for which there is no cure.

How well did you know this?

Not at all

Perfectly

What is chronic bronchitis?

Productive cough (most days) lasting longer than 3 months

How well did you know this?

Not at all

Perfectly

What is Emphysema?

Abnormal permanent enlargement of the respiratory bronchioles and alveoli

How well did you know this?

Not at all

Perfectly

What is the primary causes of Chronic Bronchitis?

Smoking 80-90% of cases
Urban pollution

How well did you know this?

Not at all

Perfectly

What is the primary causes of Emphysema?

Cigarette Smoking

What are the common signs & symptoms of COPD?

Shortness of Breath
Dyspnea (especially w/ exertion)
Orthopnea (upright breathing only)
Wheezing
Chest Tightness
Increased VR
Peripheral Cyanosis / Digital Clubbing
Ongoing or Productive Cough
Barrel Chest
Accessory Muscles during Respiration
Weight Loss
Decreased FEV1/FVC Ratio

How is COPD Diagnosed?

Signs & Symptoms
Medical & Family History
Test Results:
- Spirometry
- Arterial Blood Gases
- Chest X-Ray
- Chest CT Scan

What is a Mild COPD Classification?

< 0.70 (FEV1/FVC)

FEV1 > 80% of predicted

What is a Moderate COPD Classification?

< 0.70 (FEV1 / FVC)

50% < FEV1 > 80% of predicted

What is a Severe COPD Classification?

< 0.70 (FEV1 / FVC)

30% < FEV1 > 50% of predicted

What is a Very Severe COPD Classification?

< 0.70 (FEV1 / FVC)

FEV1 < 30% of predicted
FEV1 < 50% of predicted in presence of chronic respiratory failure

What measurement tool is considered essential for COPD diagnoses?

Spirometry

In order to minimize variability with bronchodilator values in spirometry, what is an adequate does (of what) to minimize variability?

400 ug Salbutamol

In stage 1 of COPD, what are some subjective patient identifiers associated with the symptoms?

Patient is usually unaware that his/her lung function is abnormal

In stage 2 of COPD, what are some subjective patient identifiers associated with the symptoms?

Patients typically seek medical attention b/c of chronic respiratory symptoms or an exacerbation of their disease.

In stage 3 of COPD, what are some subjective patient identifiers associated with the symptoms?

Symptoms almost have an impact on the patients quality of life.

In stage 4 of COPD, what are some subjective patient identifiers associated with the symptoms?

Quality of life is significantly impaired and exacerbations may be life threatening.

What are some COPD Treatment Goals (x5)?

What are 4 Primary COPD Treatment Goals?

1.) Improve Exercise Tolerance 2.) Advise Self-Management (ADLs) 3.) Increase Knowledge 4.) Airway Clearance

What are some COPD Lifestyle Changes & Treatments?

Smoking Cessation, Proper Nutrition, Pharmacological Therapy (Bronchodilators, Corticosteroids, Vaccines)

What is Pulmonary Rehabilitation?

Multi-Disciplinary and comprehensive intervention. - Patient Assessment - Patient Training/Education - Exercise Training - Psychosocial Interventions - Patient Follow-Up

Patients with what symptoms are candidates for Pulmonary Rehab?

- Severe Symptoms - ER/Hospital Admisions within the previous year. - Diminished ADL's - Impairments in quality of life

What are the benefits of Pulmonary Rehabilitation?

- Improvements in QOL - Increased sense of well-being - Increased self-efficacy - Increased functional capacity

What is Postural Drainage?

Getting in positions that make it easier to mucus to drain from the lungs.

In Exercise Testing for COPD Patients what are some physiological function assessments?

GXT (cardiorespiratory) & Spirometry (pulmonary)

Patient Shortness of Breath ratings for exercise testing in COPD Patients should be measured how?

Borg (1-10) Scale

What is an exercise test termination indicator in exercise testing with COPD patients?

low SPO2 (< 90%) or a drop of 3-4%

What forms of exercise are the best modalities for COPD patients?

Walking or Stationary Bicycle

What are the FITT guidelines for COPD patients?

F: > 3-5 days/wk I: SOB: < 3 (30-40% light / 60-80% vigorous) T: Small Interval bouts T: Walking and/or cycling

When can supplemental O2 be provided to a COPD patient?

Can only be provided with a prescription from a physician & with patients with low SpO2