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Pulmonology > COPD > Flashcards

COPD Flashcards

1
Q

a chronic obstructive pulmonary disease that is generally progressive and may be accompanied by airway hyperactivity

A

chronic obstructive pulmonary disease

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2
Q

when are chronic bronchitis and emphysema considered “reversible”?

A

during acute exacerbations

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3
Q

what is emphysema known as?

A

pink puffer

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4
Q

what is chronic bronchitis known as?

A

blue bloater

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5
Q

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?

A

emphysema

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6
Q

what would chest imaging show for a patient with emphysema? (3)

A

enlarged lungs
large, irregular bullae
flattened diaphragm

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7
Q

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?

A

chronic bronchitis

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8
Q

what would chest imaging show for a patient with chronic bronchitis? (2)

A

increased vascular markings
cardiomegaly

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9
Q

what is the #1 risk factor for COPD?

A

smoking

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10
Q

how would a patient present with COPD that has been present for over 10 years and today they just feel worse? (3)

A

worsening SOB, cough, and sputum

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11
Q

what can COPD exacerbations lead to?

A

respiratory distress / failure

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12
Q

what does a COPD exacerbation mimic?

A

asthma exacerbation

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13
Q

what are most COPD exacerbations triggered by?

A

respiratory infections

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14
Q

a patient presents with dyspnea worsening with exertion, digital clubbing, chronic productive cough with SOB. what are they likely experiencing?

A

COPD

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15
Q

what 6 diagnostics should/can be order for a patient with suspected COPD?

A

blood gas
CBC
spirometry
chest xray
chest CT
doppler echocardiogram

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16
Q

what would be seen in a blood gas for a patient with COPD?

A

normal pH (compensation)
increased CO2
increased HCO3

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17
Q

what would be seen in a patient’s CBC if they have COPD?

A

increased (compensation) or normal Hb and Hct

18
Q

in a spirometry, what would the results look like in a patient with COPD?

A

TLC increased
FEV1 decreased
FVC normal, until severe
FEV1/FVC ratio decreased

19
Q

what would be seen in a PA CXR for a patient with COPD?

A

hyperinflation of lungs
flattened diaphragm
increased bronchovesicular markings
vertically oriented cardiomegaly

20
Q

what would be seen in a chest CT of a patient with emphysema? (2)

A

alveolar destruction
airspace enlargement

21
Q

what would be seen in a chest CT of a patient with bronchitis? (3)

A

bronchial wall thickening
scarring
increased bronchovesicular markings

22
Q

what would be seen in a doppler echocardiogram of a patient with COPD? (2)

A

enlarged pulmonary arteries
increased pulmonary blood pressure

23
Q

what is the oxygen therapy recommendation for COPD?

A

long-term continuous O2

24
Q

what is the first line treatment for COPD?

A

SAMA - ipratropium

25
Q

what is the second line treatment for COPD?

A

albuterol - SABA

26
Q

what are the long-acting medications that can be used for COPD? (2)

A

LABA - salmeterol
LAMA - tiotropium

27
Q

what are some examples of ICS that can be used for COPD?

A

fluticasone
budesonide

28
Q

if ICS cannot be used alone for COPD, how should they be used?

A

ICS + LABA

29
Q

what combination therapy reduces COPD exacerbations?

A

ICS + LABA

30
Q

what is the fourth line treatment for COPD that should only be used when symptoms are not controlled with ICS, anticholinergics, and steroids?

A

theophylline

31
Q

what is a PDI that could be used for COPD in the future?

A

roflumilast

32
Q

what treatment for COPD is indicated for acute exacerbation and prevention or refractory, frequent exacerbations?

A

antibiotics

33
Q

what antibiotics can be use prophylactically for frequent exacerbations despite optimal medical therapy? (2)

A

azithromycin
moxifloxacin

34
Q

what is the first step for a COPD exacerbation?

A

supplemental O2

35
Q

what is the first diagnostic that should be done in a COPD exacerbation?

A

CXR - exclude other causes

36
Q

what is the second diagnostic after CXR to be done for COPD exacerbation?

A

LABS:
CBC
chemistry
blood gas

37
Q

what airway medications should be given for a COPD exacerbation?

A

SABA + SAMA
albuterol + ipratropium

38
Q

what steroids can be given for a COPD exacerbation?

A

prednisone
methylprednisolone

39
Q

what antibiotics can be given for a COPD exacerbation?

A

azithromycin

40
Q

what are 2 surgical interventions that can be done in COPD?

A

lung volume reduction
lung transplant

41
Q

when is COPD survival about 4 years?

A

FEV1 less than 1L

Pulmonology (22 decks)

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