COPD Flashcards
what makes up COPD?
chronic bronchitis and emphysema
COPD definition
common, preventable airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gasses
chronic bronchitis
productive cough for 3 months in each of two consecutive years
emphysema
permanent enlargement of the air spaces distal to terminal bronchioles that is accompanies by destruction of the airspace walls
why does emphysema cause loss of elastic recoil?
destruction of alveolar walls
what parts of the respiratory system does emphysema effect?
terminal bronchioles, alveolar ducts, and alveoli
what parts of the respiratory system does chronic bronchitis effect?
trachea and bronchi
1 cause of COPD
smoking
risk factors for COPD
smoking
occupational exposure
pack years
ppd x years smoked
who should be screened for lung cancer?
adults 50-80 who have a 20 pack year history and currently smoke or quit within the past 15 years
how is lung cancer screening performed?
low dose CT
abnormalities in the airway in COPD patients
- chronic inflammation
- increased goblet cells and mucus production
- narrowing of airways and collapse
centrilobular emphysema
upper part of acinus damages
Panacinar emphysema
entire acinus is damages
periseptal emphysema
lower part of acinusis damaged
symptoms of COPD
- dyspnea
- chronic cough
- sputum production
- wheezing and chest tightness
PE of COPD
- increased resonance to percussion
- decreased breath sounds
- yellow stains on fingers
- chronic hoarseness of voice
- barrel chest
PE findings for emphysema
- pink complexion
- thin build with barrel chest
- cough is rare
- no peripheral edema
PE findings for chronic bronchitis
- cyanotic complexion
- peripheral edema
- stocky build
- primary complaint of productive cough
comorbid conditions associated with COPD
- lung cancer
- bronchiectasis
- sleep apnea
universal screening for COPD
none
cornerstone of diagnosis for COPD
spirometry
how to determine difference between COPD and Asthma on PFT
asthma is reversible and COPD is not
interpretation of PFT for COPD diagnosis
- FEV1 less than 80%
- FEV1/FVC less than 70%
Diffusing Capacity (DLCO)
measures the ability of the lungs to transfer gas form inhaled air to the RBCs in pulmonary capillaries
use for a CXR in COPD
- evaluates for comorbidities
- identifies complications
t/f CXR is necessary for routine diagnosis of COPD
false
CXR of COPD
- hyperinflation of lungs
- flat diaphragm
- narrow heart shadow
CT has a greater sensitivity and specificity for …
emphysema
pulse ox for person with mild COPD
over 90%
pulse ox % that needs supplemental O2
less than 90%
pulse ox % that medicare will cover supplemental O2
less than 88%
What does ABG measure?
pH
PaO2
PaCO2
HCO3
when do you do an ABG?
- FEV1 less than 50% predicted
- low O2 sat
- decreased level of consciousness
- severe COPD exacerbation
ABG of mild COPD
- low pO2
- normal pCO2
ABG of moderate to severe COPD
- low pO2
- high pCO2
COPD Assessment Test (CAT)
eight question questionnaire that assessed the impact of COPD on health status