COPD Flashcards
heavy sputum production that improves and worsens is characteristic of what disease
chronic bronchitis
which obstructive disease has a chief symptom of dyspnea
emphysema
what are some later signs of COPD
barrel chest
nail clubbing
right sided HF
polycythemia
who should be screened for COPD
those with symptoms any any smokers or ex smokers over age 40
how will results of PFT post bronchodilator differ in a COPD patient compared to an asthma patient
COPD will have much less improvement post bronchodilator
if there is no history of exposure risk factors for COPD, what blood test should be done
alpha-1 antitrypsin deficiency
what breath sounds would you expect with chronic bronchitis
wheezing and rhonchi that partially clear with coughing
enlarged air sacs are seen in which kind of COPD
emphysema
what are the main causes of AECOPD
URTI and medication non compliance
what is cor pulmonale and what causes it
pulmonary vasoconstriction from hypoxemia leads to pulmonary HTN leads to right sided heart failure
what systemic symptoms will be seen with right heart failure
JVD
hepatomegaly
ascites
pedal edema
right heart failure and polycythemia is more common with chronic bronchitis or emphysema and why
chronic bronchitis
more common to have hypoxemia
what would you see on a CBC for polycythemia
increased Hg, RBC, and hematocrit
chronic bronchitis or emphysema may cause a spontaneous pneumothorax
emphysema
a pt with COPD presents with sudden onset dyspnea, and absent lung sounds on one side. What do they have and what kind of COPD is most likely
spontaneous pneumothroax
emphysema
what would a CXR show in COPD
barrel chest, hyperinflation, flat diaphragm
how do you diagnose COPD
PFTs
what should your O2 goal be in COPD and why
88-92% because chronic hypoxemia will lead to right sided heart failure
what are the indications to start O2 therapy
O2 <88%
cor pulmonale
O2 <90% WITH polycythemia
what are the goals of therapy in COPD
alleviate dyspnea
improve health status
prevent AECOPD
reduce mortality
what are the steps for treatment for COPD
1: SABA PRN
2: add LABA/LAMA
3: add ICS
4: add oxygen
Salbutamol is what class of medication
SABA
ipratroprium is what class of medication
SAMA
tiotropium is what class of medication
LAMA
formoterol is what class of medication
LABA
roflumilast is what class of medication
PDE4 inhibitor
what are the predicted FEV1 score classifications for GOLD 1-4
Gold 1 = FEV1 >/= 80%
Gold 2 50-80%
Gold 3 30-50%
Gold 4 <30%
what is the most important therapuetic intervention for COPD management
quitting smoking
what are common presenting symptoms of COPD
chronic colorless productive cough worse in the morning
dyspnea
wheezing
weight loss
why should you be cautious when using beta blockers in COPD
at high doses, it may cause bronchospasm
how often should stable COPD clients be seen
Q1-2 months
