COPD

Question 1

Cough for > 3 months in a
Year for >3 consecutive years

Is the Diagnostic criteria for […]

Answer 1

Chronic bronchitis

Question 2

DLCO
is […] in Chronic bronchitis
and […] in Emphysema

Answer 2

🟢 normal in Chronic bronchitis
🔻 low in Emphysema

Question 3

PFT in COPD has
[…] TLC, […] VC, […] FEV1/FVC

Answer 3

🔺 TLC, 🔻 VC, 🔻 FEV1/FVC

Question 4

Changes in […] may be used to follow progression in COPD patients

Answer 4

FVC

Question 5

Male, Smoker l, diffuse wheezing, normal chest XR, what is the diagnosis ?
A. Pulmonary fibrosis
B. ILD
C. COPD
D. Occupational lung disease

Answer 5

COPD

Question 6

Improve survival in COPD patients:

Answer 6

1. Smoking cessation
2. Vaccination
3. Home Oxygen “if indicated”

Question 7

Indications of home oxygen:

Answer 7

1. PaO2 <55 “2 readings, out the attack”
2. PaP2 < 59 + corpalmonale / PHTN
   + Hct >56%
   + dependent edema
3. Nocturnal hypoxia

Question 8

PO2 of […] kPa = PaO2 of 55 mmHg

Answer 8

7.3

Question 9

COPD + Cor palmonale
To improve survival […]

Answer 9

Home oxygen

Question 10

COPD not controlled on SABA ( salmeterol & albuterol ) what to give for maintenance ?

Answer 10

LAMA
Tiotropium

Question 11

Which COPD medication decrease mucous secretion ?

Answer 11

SAMA “Ipratropium Bromide”

Question 12

COPD oxygen sat% target […]

Answer 12

88-92%

Question 13

When Non-invasive mechanical ventilation (BiPaP/CPaP) is the answer for COPD patient ?

Answer 13

Patient conscious & alert

Question 14

When invasive mechanical ventilation is the answer for COPD patient ?

Answer 14

• Dec LOC
• High risk of aspiration (secretions in mouth)
• Severe acidosis (pH<7.25)

Question 15

COPD patient
Alert, has moderate resp distress
SaO2 93%
ABG: hypoxia, hypercapnia & acidosis
What is the next step?

A. Non invasive ventilation
B. Mechanical ventilation
C. Increase oxygen
D. Decrease oxygen

Answer 15

A. Non invasive ventilation

Question 16

[…] is the best was to deliver oxygen in COPD patients

Answer 16

Venture bag

Question 17

COPD patient complaining of SOB, palpitation on exam there is irregular pulse.
Best treatment:
A. Cardioversion
B. Adenosin
C. Amiodarone

Answer 17

Amiodarone

COPD associated with MAT
Tx: Digoxin or amiodarone. #1 line CCB

Question 18

COPD patient developed sudden synptoms of spontaneous pneumothorax confirmed with CXR 2cm pneumothorax. You will:

A. Do needle compression
B. Chest tube
C. Observatiob
D. Aspiration

Answer 18

Chest tube

Any 2° pneumothorax = chest tube regardless of the size

Question 19

Patient presenting with obstructive lung disease. PFTs show 🔻VC 🔻FEV1/FVC ratio
What is associated with this condition?
A. Inc lung compliance
B. Dec lung compliance
C. Weak resp muscles

Answer 19

A. Inc lung compliance

High compliance = easier to fill
(Emphysema, aging)
Low compliance = harder to fill
(Pulm fibrosis, pneumonia, pulm edema)