COPD Flashcards
a chronic obstructive pulmonary disease that is generally progressive and may be accompanied by airway hyperactivity
chronic obstructive pulmonary disease
when are chronic bronchitis and emphysema considered “reversible”?
during acute exacerbations
what is emphysema known as?
pink puffer
what is chronic bronchitis known as?
blue bloater
a patient presents with minimal V/Q mismatch since both alveoli and vessels are damaged, no hypoxemia, hypercapnia, hyperventilation to compensate for CO2, and muscle wasting due to decreased cardiac output. what are they likely experiencing?
emphysema
what would chest imaging show for a patient with emphysema? (3)
enlarged lungs
large, irregular bullae
flattened diaphragm
a patient presents with V/Q mismatch since airways are damaged but capillaries are intact, hypoxia, cyanosis, acidosis that leads to cor pulmonale, leading to right heart failure and peripheral edema. what are they experiencing?
chronic bronchitis
what would chest imaging show for a patient with chronic bronchitis? (2)
increased vascular markings
cardiomegaly
what is the #1 risk factor for COPD?
smoking
how would a patient present with COPD that has been present for over 10 years and today they just feel worse? (3)
worsening SOB, cough, and sputum
what can COPD exacerbations lead to?
respiratory distress / failure
what does a COPD exacerbation mimic?
asthma exacerbation
what are most COPD exacerbations triggered by?
respiratory infections
a patient presents with dyspnea worsening with exertion, digital clubbing, chronic productive cough with SOB. what are they likely experiencing?
COPD
what 6 diagnostics should/can be order for a patient with suspected COPD?
blood gas
CBC
spirometry
chest xray
chest CT
doppler echocardiogram
what would be seen in a blood gas for a patient with COPD?
normal pH (compensation)
increased CO2
increased HCO3
what would be seen in a patient’s CBC if they have COPD?
increased (compensation) or normal Hb and Hct
in a spirometry, what would the results look like in a patient with COPD?
TLC increased
FEV1 decreased
FVC normal, until severe
FEV1/FVC ratio decreased
what would be seen in a PA CXR for a patient with COPD?
hyperinflation of lungs
flattened diaphragm
increased bronchovesicular markings
vertically oriented cardiomegaly
what would be seen in a chest CT of a patient with emphysema? (2)
alveolar destruction
airspace enlargement
what would be seen in a chest CT of a patient with bronchitis? (3)
bronchial wall thickening
scarring
increased bronchovesicular markings
what would be seen in a doppler echocardiogram of a patient with COPD? (2)
enlarged pulmonary arteries
increased pulmonary blood pressure
what is the oxygen therapy recommendation for COPD?
long-term continuous O2
what is the first line treatment for COPD?
SAMA - ipratropium
what is the second line treatment for COPD?
albuterol - SABA
what are the long-acting medications that can be used for COPD? (2)
LABA - salmeterol
LAMA - tiotropium
what are some examples of ICS that can be used for COPD?
fluticasone
budesonide
if ICS cannot be used alone for COPD, how should they be used?
ICS + LABA
what combination therapy reduces COPD exacerbations?
ICS + LABA
what is the fourth line treatment for COPD that should only be used when symptoms are not controlled with ICS, anticholinergics, and steroids?
theophylline
what is a PDI that could be used for COPD in the future?
roflumilast
what treatment for COPD is indicated for acute exacerbation and prevention or refractory, frequent exacerbations?
antibiotics
what antibiotics can be use prophylactically for frequent exacerbations despite optimal medical therapy? (2)
azithromycin
moxifloxacin
what is the first step for a COPD exacerbation?
supplemental O2
what is the first diagnostic that should be done in a COPD exacerbation?
CXR - exclude other causes
what is the second diagnostic after CXR to be done for COPD exacerbation?
LABS:
CBC
chemistry
blood gas
what airway medications should be given for a COPD exacerbation?
SABA + SAMA
albuterol + ipratropium
what steroids can be given for a COPD exacerbation?
prednisone
methylprednisolone
what antibiotics can be given for a COPD exacerbation?
azithromycin
what are 2 surgical interventions that can be done in COPD?
lung volume reduction
lung transplant
when is COPD survival about 4 years?
FEV1 less than 1L
