COPD

Question 1

give the def of COPD

Answer 1

chronic lung diease with persisent rairflow limitation
not fully reversible

Question 2

what are the types of COPD?

Answer 2

Type A - Emphysema
Tpye B - Bronchitis

Question 3

what is the def of chronic obstructive bronchitius ?

Answer 3

chronic persistent cough with sputum
at least 3 months a year
for 2 years

Question 4

what is the def of emphysema ?

Answer 4

irreversible distention of the airways located distal to ther terminal bronchiole

destruction of septa and reduced elastic fiber

Question 5

what is the classification of emphysema

Answer 5

• centrilobular - which appears in COPD
• panacinar - in alpha 1 antitrypsin defi

Question 6

explain the subtype of centrilobular emphysema

Answer 6

abnormal dilation of respiraotry bronchiole - central portion of the acinus
assocaited with smoking

Question 7

explain the subtype panacinar

Answer 7

enlargement and descruction of all parts in acinus
seen in alpha-1 antitrypsin and in smoking

Question 8

what is the etiology of CODP?

Answer 8

smoking
pollution
genetics

Question 9

explain what alpha 1 Antitrypsin does in the lungs

Answer 9

it protects against damage

Question 10

what happens to alpha1 AT in COPD?

Answer 10

it is reduced

Question 11

where in the lungs is emphysema developed before it spreads?

Answer 11

upper part of the lungs where large bullae are formed

Question 12

define chronic bronchitis

Answer 12

thickening of the bronchial wall due to inflammation

Question 13

what happens to the mucus gland in bronchitis ?

Answer 13

hyperplasia and hypertrophy resulting in production of viscous mucus

Question 14

why is recurrent respiratory tract infections increased in bronchitis ?

Answer 14

due to damage o cilia affecting the defense mechanism

Question 15

what are the symptoms of COPD?

Answer 15

dyspnea
wheeze
frequent lower tract infections
chronic productive cough

Question 16

explain the dyspnea seen in COPD

Answer 16

progressive
worsen with exercise
MRC sclae used

Question 17

explain the MRC dyspnea scale

Answer 17

grade 1 breathless only on strenous exertion
grade 2 when waling up a slight hill
grade 3 when walking on flat ground
grade 4 walking 100 meter
grade 5 dressing/undressign

Question 18

explain the cough in COPD

Answer 18

may be intermittent and may be unproductive
commonly cough up sputum

Question 19

what are the signs seen in CODP?

Answer 19

tachypnea
tachycardia
barrel chest
accessory muscles
cyanosis
prolonged expiration
polyphonic expiraotry wheeze
CO2 retenion - confusion, tremor,
cur pulmonale
P HTN
Cachexia

Question 20

what are the finding when insepction ?

Answer 20

barrel shaped
accessory muscles
prolonged expiration
hoovers sign
tripod position

Question 21

explain the clinical manifestions

Answer 21

decreased fremitus
hyperresonant
prolongeed expiration
reduced breath sounds
wheezing
crackles - when infection occurs
diminished cardiac/hepatic dullness

Question 22

how is COPD diagnosed ?

Answer 22

spirometry
ECG
chst x ray
lab
arteiral blood gas

Question 23

what are measured in COPD in spirometry ?

Answer 23

FEV, FCV, PEF, FEV1, FEV1/FCV, VR, TLV

Question 24

what are the spirmotry values in COPD?

Answer 24

decreased FCV
decreased FEV1
decreased FEV1/FCV below 0.7
increased VR
increased TLC

Question 25

how is the diagnosis of COPD confirmed ?

Answer 25

The presence of a post-bronchodilator FEV1/FVC < 0.70 confirms the presence of persistent airflow limitation and thus of COPD

Question 26

explain the stages of the GOLD scale

Answer 26

GOLD 1 mild = FEV1 > 80% GOLD 2 moderate = 50-80% GOLD 3 severe = 30-50 % GOLD 4 very severe = < 30 %

Question 27

what can DLCO do ?

Answer 27

establish the presence of emphysema it is reduced in COPD

Question 28

how is the X ray in type A?

Answer 28

no apparent abnormality

Question 29

how is the X ray in Type B?

Answer 29

marked inflation intercostal space is widen horizzontal pattern in ribs long thin heart shadow decreased marking of lung peripheral vessel

Question 30

arterial blood gas in COPD?

Answer 30

PaO2 < 8.0 with or without PaCO2 > 6.7

Question 31

what type of respiraotry failure is seen in COPD type A?

Answer 31

Type 1 - low O2 and increased CO2 in blood

Question 32

which type of respiraotry failure is seen in COPD Type B?

Answer 32

Type 2 - CO2 > 50 mmHg

Question 33

what are the clinical manifestations of hypercapnia ?

Answer 33

headache hypercapnic encephalopathy

Question 34

what are the symptoms of hypercapnic encephalopathy ?

Answer 34

mental slowness coma flapping remor cerebral edema papillary edema

Question 35

when does hypercapnic encephalopathy opccur ?

Answer 35

when PaCO2 is over 70 mmHg

Question 36

what are the classes of bronchodilators ?

Answer 36

B2 agonists - short and long acting anticholinergic - short and long theophylline

Question 37

what are the complications of COPD?

Answer 37

pneumothorax cor pulmonale exacerbation pneumoniae respiraotory failure embolism arithmia

Question 38

what are the triggers of excerbation of CODP?

Answer 38

infections smoking exposures

Question 39

how is exacerbation treated ?

Answer 39

oxygen threapy maintain saturation 89-92 % short acting beta2 agonists oral glucocorticoids antibiotica anticoagulation in case of embolism | embolsim is increased in COPD