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Pulmonology > COPD > Flashcards

COPD Flashcards

1
Q

COPD

A

Preventable and treatable disease characterized by airflow limitation and abnormal inflammatory response in response to noxious chemicals or gases.
Slow, progressive irreversible damage due to chronic bronchitis and/or emphysema

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2
Q

COPD Fax

A

3rd leading cause of death in US

14.2 mil have it

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3
Q

COPD Risk factors

A

Smoking is leading cause
Occupational risk
Alcohol, age, gender

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4
Q

COPD Patho

A

Site of obstruction is in the smaller conducting pathways.
Destruction of alveolar support
Loss of elastic recoil
Structural narrowing sue to inflammation

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5
Q

COPD lung volume changes

A

Residual volume and functional residual capacity are increased.
Total lung capacity often increased
Vital capacity is reduced

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6
Q

Reasons for decreased vital capacity

A

Air trapping
Decreased lung recoil
Incomplete lung clearance

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7
Q

COPD is mediated by CD__ Cells

A

CD8 T lymphocytes

Asthma is CD4

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8
Q

Definition of chronic bronchitis

A

Blue bloaters

Defined as persistent cough resulting in sputum production for more than 3 months in each of the past 2 years.

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9
Q

Pathologic findings of chronic bronchitis

A

Goblet cell hyperplasia
Excess mucous secretion
Fibrosis

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10
Q

Chronic bronchitis patients develop hypoxia and cyanosis earlier than emphysema pt’s. T or F

A

T

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11
Q

Class S/S of chronic bronchitis

A

Increasingly productive cough
Dyspnea and progressive exercise intolerance
Frequent pulmonary infxns
Weight gain

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12
Q

Emphysema

A

Pink puffers
Abnormal enlargement of the airspaces distal to the terminal bronchioles.
Destruction of the alveolar walls ad capillary beds.
Abnormal airspaces called bullae compress normal lung.
Loss of lung elasticity

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13
Q

Emphysema Causes

A

Smoking

Alpha-1 antitrypsin deficiency

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14
Q

Emphysema presentation

A 
Long hx of progressive dyspnea
Non-productive cough
Initially able to over-ventilate and maintain normal blood gas levels
Patients are usually cachectic
Pursed lip breathing is helpful
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15
Q

Centrilobular Emphysema

A

Most common type
Characterized by focal destruction
Seen predominantly in male smokers
Most severe in upper lobes

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16
Q

Panlobular Emphysema

A

Involves entire alveolus distal to the temrinal bronchiole.
Most severe in lower lung zones
Generally in patients with AAT deficiency

17
Q

Alpha-1 Antitrypsin Deficiency

A

Congenital
Should be considered in young patients who show signs of emphysema
Typically develop dyspnea around age 30-45 yo
Usually Scandinavian descent

18
Q

What does AAT do?

A

Serves as protective screen that protects alveolar walls

19
Q

Emphysema Labs

A

AAT levels
Chest x-ray
Chest CT

20
Q

AAt deficiency tx

A

Treat with Prolastin

Weekly infusions of AAT protein

21
Q

Physical signs of COPD

A 
Barrel chest
Accessory muscle use
Peripheral cyanosis
Clubbing
Decreased breath sounds
Hyper-resonance on percussion
Low, flat diaphragm
22
Q

COPD advanced disease findings

A 
Intervals btw exacerbations becomes shorter
Cyanosis
SIgnificant hypoxia
Polycythemia
Pulmonary HTN
R sided heart failure
23
Q

COPD blood gas findings

A

Low pH
Hypercapnia
Renal compensation

24
Q

Cor Pulmonale

A

Pulmonary HTN
R sided heart failure
Poor gas exchange
Constriction of blood vessels

25
Q

COPD complications

A

Pneumonia (strep)
Pneumothorax
Secondary polycythemia

26
Q

COPD Tx

A

Smoking cessation
Pulmonary rehab
Immunizations
Medications

27
Q

COPD Medical tx

A

Log-acting Bronchodilators

Inhaled Steroids

28
Q

Mucolytics

A

Associated with reduction of exacerbations

Should be considered for winter months

29
Q

Long-term oxygen therapy

A

Only treatment shown to prolong survival.

Patients with O2 sat <90 should receive oxygen.

30
Q

Lung Volume Reduction Surgery

A

Removal of diseased lung tissue letting the healthy tissue fxn better.
Not a cure, improved quality of life.

31
Q

1st line Abx for COPD exacerbation

A

Septra
Amoxacillin
Doxycycline

32
Q

Acute exacerbation Tx

A

Oxygen
Inhaled Bronchodilators
Glucocorticoids
Abx

33
Q

D/C criteria for COPD exacerbation

A

Use of inhaled bronchodilators less frequently than every 4 hrs
Clinical and ABG stability for 12-24 hrs
Can eat, sleep and ambulate

34
Q

Bronchiectasis

A

Requires infectious insult and impaired drainage.
Results in blockage and inflammation, mucosal edema, ulceration.
Permanent abnormal dilation and destruction of major bronchi and bronchiole walls

35
Q

Bronchiectasis Etiologies

A

Often caused by recurrent inflammation and infxn.
May be present at birth
Defective host defenses
Cystic fibrosis is major cause.

36
Q

Bronchiectasis Presentation

A 
Symptoms may develop gradually.
Chronic cough, foul smelling sputum
Hemoptysis
Weight loss
Fatigue
Clubbing, cyanosis, wheezing
37
Q

Bronchiectasis Tx

A 
Treat infxn (long-term abx)
Mucolytics
Removal of possible obstruction
Physiotherapy
Vaccination

Pulmonology (15 decks)

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