Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Internal Medicine- Chest > COPD > Flashcards

COPD Flashcards

1
Q

What is pink puffer ?

A

Emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is blue bloater?

A

Chronic Bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the differential diagnoses of hemoptisis and the most common?

A
  1. Bleeding disorder
  2. mitral Stenosis
  3. Heart failure
  4. Bronchitis (MC)
  5. Bronchiactesis
  6. Pneumonia
  7. Pulmonary TB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Compare acute and chronic bronchitis

A

Cough: dry then productive vs productive

Duration: less than 3w vs at least 3w for consecutive years

Etiology: viral vs smoking

Patient: less than 5 vs male adult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the stages of bronchitis?

A

-chronic simple bronchitis: hypertrophy of mucus glands leading to white mucoid discharge
- Chronic mucopurulent bronchitis: 2ndry bacterial infection (strept pn or H influenza) leading to yellow sputum
- Chronic obstructive bronchitis: mucus plugs and fibrosis leading to blue bloater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is emphysema?

A

Abnormal permanent dilation of spaces distal to terminal bronchioles leading to loss of elastic recoil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the inheritance of alpha 1 antitrypsin deficiency

A

AR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the types of emphysema ?

A

True: congenital (alpha 1) or acquired (smoking)

False: senility and compensatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Compare alpha 1 antitrypsin def and smoking on their effect on the lung

A

Alpha 1: pan acinar lower
Smoking: centri acinar upper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Compare pink puffer and chronic bronchitis (without examination)

A

Age: 50s vs 40s

Symptom: more severe Dyspnea than cough more severe cough than dyspnea

Complication:
• pneumothorax or Bullae
• exaccerbations/ 2ndry polycythemia/ corpulmonale

Prognosis good vs bas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Compare between pink puffer and blue bloater regarding examination:

A

General examination:

•Flushed and working accessory muscles
• weight loss
• tripod position
• pursed lip breathing

• central cyanosis
• weight gain
• peripheral edema
• pulmonary htn

Local examination:

Inspection: increased AP normal AP
Percussion: hyperresosanance vs normal
Ausculation: decreased sound vs harsh vesicular

No Ronchi vs ronchi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Compare pink puffer and blue bloater regarding investigations:

A

CXR: • decreased bronchivascular marking, jet black lungs, ribbon shaped heart, low flat diaphragm and horizontal ribs

• increased bronchovacular marking, normal sized lungs with or without right ventricular hypertrophy

ABG:

Hypoxia and normocapnia/hypocapnia
Hypoxia and hypercapnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Compare pink puffer and blue bloater regarding investigations:

A

CXR: • decreased bronchivascular marking, jet black lungs, ribbon shaped heart, low flat diaphragm and horizontal ribs

• increased bronchovacular marking, normal sized lungs with or without right ventricular hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is COPD and its RF?

A

Chronic Obstructive Lung disease
1- Def: Umbrella term used to describe diseases that are cc by chronic progressive partially reversible
airway obstruction
2- R.F.: Smoking (Pack year 20 or more)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give 3 examples of COPD

A

Refractory asthma
Emphysema
Chronic bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the Clinical picture of a COPD patient

A

a- TOP: Old Heavy smoker

b- Symp.: Blue bloater or Pink puffer
Dyspnea

c- Signs:

1- G

a- Pulse = Pulsus Paradoxus or Arrhythmias

b- Head & Neck
1- Congested pulsating neck veins with Kussmaul’s sign

2- Tachypnea + Working accessory ms

  1. LL edema

2- L

I: Symmetrical, equal movement & increased A-P diameter, Hyper-inflation

P: Trachea (Centralized), TVF (Equal)

P: Bilateral hyper-resonance + Encroaching on heart & liver

A:
a- Breath S.: Type: Harsh vesicular (Prolonged expiration) + decreased Air entry Bilaterally

b- Additional S: Coarse crepitations + Rhonchi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the differential diagnosis of dyspnea?

A
  1. Anaphylaxis
  2. Cardiac Tamponade
  3. Mycardial Infarction
  4. Foreign body Inhalation
  5. Bronchial Asthma
  6. AECOPD
  7. Pneumothorax
    8.Pulmonary embolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the investigations of COPD?

A

4- Invest.:

A- LAB.:

1- Sputum culture (Exacerbation)/ dec AT, 2ry Polycythemia

2- ABG = dec POz ‡ inc PCOz (Blue bloater) or Normal PCO2 (Pink puffer)

3- DLco = Impaired (Pink puffer)

B- RAD.: Blue bloater + Pink puffer

C- INST.: Spirometry
Obstructive Hypoventilation pattern inc TLC, dec FVC, dec FEV1

Post Broncho-dilator Ratio of FEVI/FVC < 0.7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the complications of COPD?

A

Complications

1- Acute exacerbation (airway inflammation)

2- Lung
(Pnthx, Bronchiectasis, Pneumonia, Cancer & Resp. F )

3- Heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

COPD types

A

Type A emphysema
Type B Chronic bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the hallmark picture of COPD?

A

Dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the arrhythmias of COPD and the most common ones ?

A

Multiracial Atrial Tachycardia (mc)
Atrial fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What feature is not a feature of COPD and what does its presence indicate?

A

Clubbing

Bronchiactesis or Cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Explain the etiology of LL edema in COPD

A

Corpulmonale
Decrease in cop
Increase in Raas
Decrease O2 so increase in permeability
Increased CO2 leading to acidosis and increase in NaHCO3 reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How are acute exacerbations classified in COPD ?

A

Based on the presence of cardinal features

Increased Dyspnea
Increased sputum
Increased purulence

Mild
Moderate
Severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What type of RF does a COPD patient experience

State it’s ABG

A

Type 2

O2 below 60
CO2 above 50

27
Q

What does GOLD stand for (w menha t3rf its use)

A

Global Initiative for Lung Disease

28
Q

What are the 3 corner stones of GOLD

A

Risk of Annual Exacerbations
Dyspnea Grades

Spirometry grades

29
Q

Post bronchodilator test in COPD
Fev1/fvc is

A

Less than 0.7

30
Q

List Gold levels

A

Gold 1 at least 80
Gold 2 80-50
Gold 3 50-30
Gold 4 less than 30

31
Q

Dyspnea severity is measured by

A

Mmrc scale

32
Q

COPD A Grade ttt and Diagnosis

A
  • 0 or 1 Dyspnea severity
    AND
  • no or 1 without hospitalization

SABA as needed

33
Q

What is the most common cause of AECOPD ? And percentage and etiology stating the Mac

A

Infection 75%

Rhinovirus Mc
Strept pneumoniae
H influenza

34
Q

COPD grade B diagnosis and ttt

A
  • 2,3 or 4Dyspnea severity
    AND
  • no or 1 without hospitalization

LABA AND LAMA ON REGULAR BASIS

35
Q

C + D =

A

E

36
Q

What is C grade diagnosis?

A
  • 0 or 1 Dyspnea severity
    AND
  • 2 or more and must require hospitalization
37
Q

What is D grade diagnosis?

A
  • 2,3 or 4 Dyspnea severity
    AND
  • 2 or more and must require hospitalization
38
Q

What is grade E ttt?

A

If esinophils are at least 300 cell per microliter add ICS on regular basis

39
Q

What are the vaccinations that COPD patients can benefit from ?

A

Pcv 13
Influenza

40
Q

When should pulmonary rehabilitation start?

A

Grade B

41
Q

What is the advantage of Venturi mask ?

A

Improves quality of life

42
Q

When to start Venturi mask ?

A

PO2 55 or less
Or
PO2 less than 60 with PTH

43
Q

What is Venturi mask ?

A

Long term low flow oxygen therapy

44
Q

What are the lines of TTT of COPD?

A

Community
1. Patient education (smoking cessation, respiratory muscle exercise and vaccination)

Pulomonolgy
2. Pulmonary rehabilitation

  1. Venturi mask

Internist
4. Symptomatic treatment of cough

  1. Group ttt as needed

Surgical
6. Surgical intervention

45
Q

All grades of COPD require dual therapy of bronchodilators except

A

A

46
Q

What surgical interventions can COPD benefit from ?

A

Bullectomy
Lung volume reduction
Transplantation

47
Q

Describe how to treat a cough.

A

Dry: Codiene 10ml max 4 times a day
Productive:

Productive
Mucolytic (N acetyl cysteine) 200mg max 3 times a day

Expectorant (Guaifenesin) 200mg max 12 times a day

48
Q

In COPD which route is it choice ?

A

Inhalation

49
Q

Most important factor to stop progression of COPD

A

Smoking cessation

50
Q

List bronchodilators you could use

A

B2 agonist
M3 antagonists
Methylxanthines (as theophylines pde 3 and 4 inhibitors)

51
Q

Which type of bronchodilators are used for maintenance and control ?

A

Long acting bronchodilators

52
Q

Long acting anti M3 or Long acting b2 agonists

Which are superior to which in exacerbations?

A

LAMA

53
Q

Which are more superior in controlling Dyspnea ?

B2 agonist
ICS
M3 antagonist

A

B2 agonist
ICS

54
Q

Which are more superior in controlling clinical picture ?

B2 agonist
ICS
M3 antagonist

A

B2 agonists
ICS

55
Q

What musnt be used for long term COPD treatment (we can use them fel exacerbation 3ady) and why

A

ICS and steroids

Percipitate pneumonia

56
Q

What should only be used in case there are no long acting bronchodilators (considered the last resort)?

A

Theophyline

57
Q

What should only be used in case there are no long acting bronchodilators (considered the last resort)?

A

Theophyline

58
Q

What is better to start with

And except in

A

Long acting inhalers

mild occasional dyspnea

59
Q

In AECOPD
What should we use IV or oral

A

Both are of the same efficacy
Only use iv if patient is unable to swallow

60
Q

Explain the etiology AECOPD

A

a- Etio.:
1- Infections
2- Exposure to pollution, Allergens, Chemicals & Cold weather
3- Pt. non-compliance
4- Heart failure, P. Embolism, Arrhythmias

61
Q

Explain C/P of AECOPD

A

b- C/P:

Cardinal Features (inc Dyspnea, inc Sputum Amount, inc Sputum Purulence)

Other Features
(Fever, Upper Resp. Tract infection, inc
HR, R.R., Wheezes, Cough)
(Cyanosis & LL edema)

62
Q

Explain TTT of AECOPD

A

c- TT:
1- Mild (inc Dose of TTT)
2- Moderate (Add Oral Steroids ‡ ABs)
3- Severe (Needs Hospitalization up to CU)

63
Q

What is the most common infection in AECOPD?

A

Street pneumoniae

Internal Medicine- Chest (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions