COPD

Question 1

Structural changes of the airway and alveoli that results in chronic respiratory symptoms and airflow limitations that is NON-REVERSIBLE

Answer 1

COPD

Question 2

What two diseases fall under COPD?

Answer 2

Chronic Bronchitis
Emphysema

Question 3

Patients with COPD typically have a history of?

Answer 3

Smoking

Question 4

Pathological term describing destruction of gas exchanging surfaces on the lung alveoli resulting in a reduction of normal elastic recoil of the lung parenchyma.

Answer 4

Emphysema

Question 5

Cough and sputum production for more than 3 months a year for at least 2 consecutive years in the absence of other conditions that might cause symptoms.

Answer 5

Chronic Bronchitis

Question 6

Do patients with COPD have a difficult time getting air in or out of their lungs?

Answer 6

Out

Question 7

What is the basis of diagnosis for COPD?

Answer 7

Spirometry

Question 8

If a patient has reduced FEV1 and the ratio of FEV1/FVC is low, what does this indicate?

Answer 8

Airflow Obstruction

Question 9

An increase in residual volume and total lung capacity indicates what?

Answer 9

Air Trapping and Hyperinflation

Question 10

A test used to measure how effectively the lungs transfer oxygen from inhaled air in the blood.

Answer 10

DLCO

Question 11

What are the indications to measure ABGs?

Answer 11

Hypoxemia or Hypercapnia
FEV1 or DLCO less than 40% of predicted.

Question 12

Oxygen concentration typically higher in the Alveoli (PA) or in the Arteries of the Lungs (Pa)? By how much?

Answer 12

Alveoli (PA)
5 - 10 mmHg

Question 13

For a patient with COPD who is an active smoker, what is the primary treatment?

Answer 13

Smoking Cessation

Question 14

What vaccines can be given to patients with COPD to help prevent exacerbation?

Answer 14

Flu
COVID
Pneumococcal

Question 15

Post-Bronchodilator FEV1/FVC of less than what would indicate COPD?

Answer 15

Less than 0.7

Question 16

COPD Gold 1

Answer 16

FEV1 of 80% or greater

Question 17

COPD Gold 2

Answer 17

FEV1 50 - 79%

Question 18

COPD Gold 3

Answer 18

FEV1 30 - 49%

Question 19

COPD Gold 4

Answer 19

FEV1 of less than 30%

Question 20

Group A and B Criteria (COPD)

Answer 20

0 or 1 moderate exacerbations
(not leading to hospitalization)

Question 21

Group E Criteria (COPD)

Answer 21

2 or more exacerbations
1 or more hospitalizations

Question 22

Group A mMRC (COPD)

Answer 22

0 - 1

Question 23

Group B mMRC (COPD)

Answer 23

≥ 2

Question 24

Group A (COPD) Treatment

Answer 24

Bronchodilator

Question 25

Group B (COPD) Treatment

Answer 25

LABA + LAMA
(Formoterol + Tiotropium)

Question 26

Group E (COPD) Treatment

Answer 26

LABA + LAMA
+ ICS (if EOS ≥ 300)

Question 27

Medication used to reduce bronchoconstriction and mucous secretions

Answer 27

Short-Acting Muscarinic Antagonist
(SAMA)

Question 28

Medication used to relax muscles in the airways.

Answer 28

Short-Acting Beta Agonist
(SABA)

Question 29

Medication that is used for COPD patient who don’t improve enough with other medications. Relaxes smooth muscle of the bronchial airways and pulmonary blood vessels and reduces airway responsiveness. Seen as a last resort medication. Requires monitoring due to toxicity.

Answer 29

Theophylline

Question 30

Medication that is used for moderate or severe COPD with frequent exacerbations in patients who are taking LABA and ICS or LAMA.

Answer 30

Phosphodiesterase Type 4 Inhibitor
(Bronchodilator + Anti-Inflammatory)

Question 31

What is the only treatment known to directly lengthen the life of COPD patients?

Answer 31

Oxygen

Question 32

PaO2 of less than 56 mmHg

Answer 32

Hypoxemia

Question 33

What is the target oxygen saturation for an inpatient COPD patient?

Answer 33

90 - 94%

Question 34

When should you admit a patient with COPD to the hospital?

Answer 34

• Severe symptoms or acute worsening that fails to respond to outpatient management
• Hypoxemia
• Hypercapnia
• Peripheral edema
• Altered Mental Status
• Inadequate home care
• High Risk Comorbidities

Question 35

How do you treat an inpatient COPD patient?

Answer 35

Oxygen
SABA + SAMA
Corticosteroids
Broad-Spectrum ABX

Question 36

Genetically inherited condition characterized by the impaired production of the alpha-1 anti-trypsin protein. This protein protects the body from neutrophil elastase, an enzyme released during inflammation and infection.

Answer 36

Alpha 1 Anti-Trypsin Deficiency.

Question 37

What conditions are caused by Alpha 1 Anti-Trypsin Deficiency?

Answer 37

Emphysema and Bronchiectasis

Question 38

When do symptoms of Alpha 1 Anti-Trypsin usually appear in life?

Answer 38

As early as 20

Question 39

What is the only licensed treatment of Alpha 1 Anti-Trypsin Deficiency?

Answer 39

Infusion of pooled plasma-purified human alpha-1 anti-trypsin.

Question 40

A chronic lung condition that leads to widening and scarring of the airways. Results in a chronic, often progressive, suppurative lung disease.

Answer 40

Bronchiectasis

Question 41

What can cause bronchiectasis?

Answer 41

Cystic Fibrosis
Severe or Recurrent Infections
Autoimmune Conditions
Radiation
Idiopathic
Inhaled Objects

Question 42

When is Bronchiectasis most commonly seen in life?

Answer 42

At or After middle age
(could be present at birth though)

Question 43

What are some complications of bronchiectasis?

Answer 43

Clubbing
Cyanosis
Wheezing
Inspiratory Crackles

Question 44

How do you test for Bronchiectasis?

Answer 44

CT Scan
- Greater than 0.8 for abnormality in children
- Greater than 1 - 1.5 in Adults
X-Ray
- often nonspecific or normal

Question 45

How do you treat Bronchiectasis?

Answer 45

Humidifiers
Long-Term ABX (with 3 or more exacerbations per year)
Expectorants and Mucolytics
Lung Resection
Lung Transplant