COPD

Question 1

3rd cause of death in US

Answer 1

COPD (4th in world)

Question 2

inflammation causes

Answer 2

small airway dz and parenchymal destruction –>air flow limitation

Question 3

small airway dz –>

Answer 3

airway inflammation and airway remodeling

Question 4

parenchymal destruction –>

Answer 4

loss of alveolar attachments and decreased of elastic recoil

Question 5

pursed lip breathing is a/w

Answer 5

emphysema

Question 6

hypoxemia and respiratory acidosis and hypercarbia more common w/

Answer 6

chronic bronchitis

Question 7

corpulmonale from pulmonary HTN

Answer 7

chronic bronchitis

Question 8

blue bloaters

Answer 8

chronic bronchitis

Question 9

pink puffers

Answer 9

emphysema

Question 10

chronic bronchitis (CB)

Answer 10

chronic productive cough for 3 months during 2 consecutive yrs with no other cause

Question 11

obstruction in CB

Answer 11

inspiratory and expiratory

Question 12

emphysema

Answer 12

pathologic enlargement of the air spaces distal to the terminal bronchioles due to DESTRUCTION OF ALVEOLAR WALL

Question 13

obstruction is emphysema

Answer 13

exhalation

Question 14

inflammation by neutrophils a/w

Answer 14

CB

Question 15

inflammation by eosinophil a/w

Answer 15

asthma

Question 16

persistent to sever cough and sputum in

Answer 16

CB

Question 17

dyspnea in emphysema

Answer 17

progressive, constant, sever

Question 18

dyspnea in CB

Answer 18

intermittent, mild to moderate

Question 19

sputum appearance in CB vs. emphysema

Answer 19

mucopurulant in CB vs clear-mucoid in emphysema

Question 20

cardinal symp of COPD

Answer 20

dyspnea, chronic cough, sputum

Question 21

genetic risk factor of COPD

Answer 21

alpha 1-antitrypsin def.

Question 22

polycythemia on CBC

Answer 22

COPD

Question 23

hallmark of dx of COPD

Answer 23

PFTs

Question 24

CXR findings for emphysema

Answer 24

1. hyperinflation ~w/bullae2. flattening of diaphragm 3. enlargement of retrosternal air space

Question 25

CXR findings for CB

Answer 25

1. cardiac enlargement 2. pulm congestion 3. increased lung markings

Question 26

hyperinflation ~w/bullae

Answer 26

emphysema

Question 27

cardiac enlargement

Answer 27

CB

Question 28

flattening of diaphragm

Answer 28

emphysema

Question 29

enlargement of retrosternal air space

Answer 29

emphysema

Question 30

increased lung markings

Answer 30

CB

Question 31

pulm congestion

Answer 31

CB

Question 32

PFTs

Answer 32

FVC (forced vital capacity), FEV1 (forced expiratory volume in 1 sec), FEV1/FVC

Question 33

FVC in COPD

Answer 33

normal (vs. low in restrictive dz)

Question 34

FEV1 is decreased in

Answer 34

obstructive dz

Question 35

normal value of FEV1/FVC

Answer 35

70-80%

Question 36

decreased FEV1 with nl FVC

Answer 36

obstructive dz

Question 37

5 A approach to smoking cessation

Answer 37

ask about tobacco, advise to quit, access willingness, assist , arrange f/u and support

Question 38

mainstay of COPD tx

Answer 38

bronchodilators (B2 agonist and anticholinergics)

Question 39

PDE-4 inhibitor

Answer 39

anti-inflammatory effect-inhibits infiltration

Question 40

Roflumiast

Answer 40

PDE- used in refractory cases

Question 41

mucolytic agents

Answer 41

not for out pt. used in pt w/ thick, tenacious pulmonary secretion

Question 42

antiprotease therapy

Answer 42

for pts w. alpha1-antitrypsin def.

Question 43

indications for O2 therapy

Answer 43

pO2 < 55 or O2 sat <88%

Question 44

purse lip breathing for COPD

Answer 44

more air expelled

Question 45

most common organism for lower RI

Answer 45

H flu, S pnemo, Moraxella cath, pseudomonas aeruginosa