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Pneumology > COPD > Flashcards

COPD Flashcards

1
Q

give the def of COPD

A

chronic lung diease with persisent rairflow limitation
not fully reversible

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2
Q

what are the types of COPD?

A

Type A - Emphysema
Tpye B - Bronchitis

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3
Q

what is the def of chronic obstructive bronchitius ?

A

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

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4
Q

what is the def of emphysema ?

A

irreversible distention of the airways located distal to ther terminal bronchiole

destruction of septa and reduced elastic fiber

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5
Q

what is the classification of emphysema

A
  • centrilobular - which appears in COPD
  • panacinar - in alpha 1 antitrypsin defi
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6
Q

explain the subtype of centrilobular emphysema

A

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

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7
Q

explain the subtype panacinar

A

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

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8
Q

what is the etiology of CODP?

A

smoking
pollution
genetics

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9
Q

explain what alpha 1 Antitrypsin does in the lungs

A

it protects against damage

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10
Q

what happens to alpha1 AT in COPD?

A

it is reduced

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11
Q

where in the lungs is emphysema developed before it spreads?

A

upper part of the lungs where large bullae are formed

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12
Q

define chronic bronchitis

A

thickening of the bronchial wall due to inflammation

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13
Q

what happens to the mucus gland in bronchitis ?

A

hyperplasia and hypertrophy resulting in production of viscous mucus

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14
Q

why is recurrent respiratory tract infections increased in bronchitis ?

A

due to damage o cilia affecting the defense mechanism

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15
Q

what are the symptoms of COPD?

A

dyspnea
wheeze
frequent lower tract infections
chronic productive cough

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16
Q

explain the dyspnea seen in COPD

A

progressive
worsen with exercise
MRC sclae used

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17
Q

explain the MRC dyspnea scale

A

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

18
Q

explain the cough in COPD

A

may be intermittent and may be unproductive
commonly cough up sputum

19
Q

what are the signs seen in CODP?

A

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

20
Q

what are the finding when insepction ?

A

barrel shaped
accessory muscles
prolonged expiration
hoovers sign
tripod position

21
Q

explain the clinical manifestions

A

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

22
Q

how is COPD diagnosed ?

A

spirometry
ECG
chst x ray
lab
arteiral blood gas

23
Q

what are measured in COPD in spirometry ?

A

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

24
Q

what are the spirmotry values in COPD?

A

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

25
Q

how is the diagnosis of COPD confirmed ?

A

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

26
Q

explain the stages of the GOLD scale

A

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

27
Q

what can DLCO do ?

A

establish the presence of emphysema
it is reduced in COPD

28
Q

how is the X ray in type A?

A

no apparent abnormality

29
Q

how is the X ray in Type B?

A

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

30
Q

arterial blood gas in COPD?

A

PaO2 < 8.0 with or without PaCO2 > 6.7

31
Q

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

A

Type 1 - low O2 and increased CO2 in blood

32
Q

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

A

Type 2 - CO2 > 50 mmHg

33
Q

what are the clinical manifestations of hypercapnia ?

A

headache
hypercapnic encephalopathy

34
Q

what are the symptoms of hypercapnic encephalopathy ?

A

mental slowness
coma
flapping remor
cerebral edema
papillary edema

35
Q

when does hypercapnic encephalopathy opccur ?

A

when PaCO2 is over 70 mmHg

36
Q

what are the classes of bronchodilators ?

A

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

37
Q

what are the complications of COPD?

A

pneumothorax
cor pulmonale
exacerbation
pneumoniae
respiraotory failure
embolism
arithmia

38
Q

what are the triggers of excerbation of CODP?

A

infections
smoking
exposures

39
Q

how is exacerbation treated ?

A

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

embolsim is increased in COPD

40
Q
A

Pneumology (10 decks)

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