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IM Pulmo > COPD > Flashcards

COPD Flashcards

1
Q

What is the global rank of COPD as a cause of death?

A

3rd cause of death worldwide

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2
Q

What are the persistent symptoms of COPD?

A

Respiratory symptoms and airflow limitation that is not fully reversible

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3
Q

What test is used to determine chronic airflow obstruction in COPD?

A

Spirometry

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4
Q

What is the most common environmental factor leading to COPD?

A

Cigarette smoking

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5
Q

What characterizes emphysema in COPD?

A

Destruction of lung alveoli with air space enlargement distal to terminal bronchioles

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6
Q

How is chronic bronchitis clinically defined?

A

Chronic cough and sputum production for at least 3 months per year over 2 consecutive years

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7
Q

What are the most common risk factors for COPD?

A

Tobacco smoking, air pollutants, occupational dusts, chemicals, infections, and genetic α1-antitrypsin deficiency

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8
Q

What causes the chronic airflow limitation in COPD?

A

A mixture of small airways disease and parenchymal destruction

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9
Q

What inflammatory cells are triggered by chronic exposure to cigarette smoke?

A

Macrophages, neutrophils, T lymphocytes, and B lymphocytes

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10
Q

What imbalance contributes to extracellular matrix destruction in COPD?

A

Protease-antiprotease and oxidant-antioxidant imbalance

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11
Q

What are the main pathophysiologic findings in COPD?

A

Persistent reduction in FEV1, air trapping, and ventilation-perfusion mismatching

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12
Q

What defines centrilobular emphysema?

A

Enlarged air spaces in respiratory bronchioles, typically in the upper lobes

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13
Q

Which type of emphysema is associated with α1-antitrypsin deficiency?

A

Panlobular emphysema

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14
Q

What is the hallmark symptom of COPD?

A

Dyspnea

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15
Q

What physical finding indicates advanced COPD?

A

Barrel-shaped chest, hyperresonance on percussion, and use of accessory muscles

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16
Q

How is chronic bronchitis distinct from emphysema in terms of symptoms?

A

Chronic bronchitis involves a productive cough and cyanosis, while emphysema involves minimal cough and cachexia

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17
Q

What is the GOLD criterion for severe COPD?

A

FEV1 between 30% and 50% of predicted

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18
Q

What questionnaire is used to assess the severity of dyspnea in COPD?

A

Modified Medical Research Council (mMRC) Questionnaire

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19
Q

What is the primary basis for the Refined ABCD Assessment?

A

Respiratory symptoms and exacerbation history

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20
Q

What is the first step in managing COPD?

A

Smoking cessation

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21
Q

What combination therapy is preferred for managing mild exacerbations in COPD?

A

LAMA + LABA

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22
Q

What surgical option is available for patients with non-functional lung tissue in COPD?

A

Lung volume reduction surgery

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23
Q

What non-pharmacological therapy improves exercise tolerance in COPD?

A

Pulmonary rehabilitation

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24
Q

Why do not all smokers develop COPD?

A

Favorable DNA mutations and larger airway-to-lung size ratio

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25
Q

What are the key imaging findings in emphysema?

A

Flattened hemidiaphragms, hyperlucent airways, and bullae on CT scan

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26
Q

What type of emphysema spares central areas and is distributed along pleural margins?

A

Paraseptal emphysema

27
Q

What is the role of α1AT augmentation therapy in COPD?

A

Used for patients with α1-antitrypsin deficiency

28
Q

What environmental factors besides smoking contribute to COPD?

A

Air pollutants and occupational exposures

29
Q

What genetic deficiency increases the risk of early-onset COPD?

A

α1-antitrypsin deficiency

30
Q

What is the primary mechanism by which cigarette smoke damages the lungs?

A

Triggers inflammatory and immune cell recruitment

31
Q

Which type of inflammation is central to COPD pathogenesis?

A

Chronic inflammation leading to structural changes

32
Q

How does small airway disease manifest in COPD?

A

Narrowed and reduced small bronchioles

33
Q

What cellular imbalance leads to emphysema?

A

Protease-antiprotease imbalance

34
Q

What type of metaplasia is observed in large airways of COPD patients?

A

Squamous metaplasia

35
Q

Which lung cells are increased but have reduced phagocytic capacity in COPD?

A

Macrophages

36
Q

What causes the hyperinflation observed in COPD?

A

Air trapping due to expiratory outflow obstruction

37
Q

What is the typical appearance of lungs in emphysema on gross examination?

A

Enlarged air spaces with destruction of alveolar walls

38
Q

What histopathologic feature differentiates emphysema from chronic bronchitis?

A

Destruction of alveolar walls in emphysema

39
Q

What differentiates pink puffers from blue bloaters in COPD?

A

Pink puffers have minimal cough and cachexia; blue bloaters have chronic cough and cyanosis

40
Q

At what FEV1 level does PaCO2 elevation become expected in COPD?

A

FEV1 <25% of predicted

41
Q

What is the clinical significance of the RV/TLC ratio in COPD?

A

Indicates air trapping and hyperinflation

42
Q

Why is pulmonary rehabilitation important in COPD?

A

Improves exercise tolerance and well-being

43
Q

What role does roflumilast play in COPD management?

A

PDE-4 inhibitor with anti-inflammatory properties

44
Q

How does long-term oxygen therapy benefit COPD patients?

A

Prevents pulmonary hypertension and cor pulmonale in hypoxemic patients

45
Q

What is the purpose of intrabronchial valves in COPD treatment?

A

Deflate hyperinflated lung segments to reduce lung volume

46
Q

What imaging findings are pathognomonic for emphysema?

A

Bullae and hyperlucent airways

47
Q

What does ventilation-perfusion mismatch lead to in COPD?

A

Gas exchange abnormalities

48
Q

Which COPD patients are candidates for lung transplantation?

A

Advanced disease with severe functional impairment

49
Q

What findings on physical exam suggest advanced COPD?

A

Cachexia, bitemporal wasting, and barrel chest

50
Q

What cytokines are involved in COPD-related inflammation?

A

TNF-α and IL-8

51
Q

What is the impact of elastin destruction in COPD?

A

Airspace enlargement and emphysema formation

52
Q

Why are COPD patients prone to respiratory infections?

A

Impaired mucociliary clearance and inflammation

53
Q

How does the CAT assessment differ from mMRC?

A

CAT quantifies COPD impact; mMRC focuses on dyspnea severity

54
Q

What structural changes occur in small airways of COPD patients?

A

Goblet cell metaplasia, smooth muscle hypertrophy, and luminal narrowing

55
Q

What is the clinical utility of the GOLD criteria?

A

Defines airflow obstruction severity based on spirometry

56
Q

Which type of emphysema is focal and often seen in smokers?

A

Centrilobular emphysema

57
Q

What systemic effect is associated with COPD cachexia?

A

Hypercatabolic state due to elevated inflammatory cytokines

58
Q

Why is spirometry critical in COPD diagnosis?

A

Confirms airflow limitation and assesses severity

59
Q

What is the significance of Hoover’s sign in COPD?

A

Paradoxical inward movement of the rib cage during inspiration

60
Q

What interventions help reduce COPD exacerbations?

A

Smoking cessation, vaccines, and pharmacotherapy like LAMA/LABA

61
Q

What is the role of PDE-4 inhibitors in COPD?

A

Reduce inflammation and exacerbations in severe COPD patients

62
Q

How do proteases contribute to COPD?

A

Destroy extracellular matrix and alveolar walls

63
Q

What imaging technique is best for detecting bullae in COPD?

A

CT scan

IM Pulmo (5 decks)

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