COPD

Question 1

risk factors

Answer 1

smoking
occupational or environmental exposure
risk of known deficiency of alpha-1 anti trypsin

Question 2

symptoms

Answer 2

chronic cough
chronic phlegm
dyspnea
recurrent wheeze

Question 3

physical exam

Answer 3

increase respiratory rate
shallow breaths
pursed lips during exhalation
accessory muscle use
cyanosis
finger clubbing (sign of additional lung disorder)

Question 4

assessment

Answer 4

pulmonary function test (PFT): preformed when risk factors and symptoms suggestive of COPD

chest radiography: done during initial assessment

blood gases: stable COPD patients will have compensated arterial pH of 7.35-7.4 with elevated pCO2 >40mmHg and high bicarbonate >24

Question 5

gold 1

Answer 5

mild
FEV1>80%

Question 6

gold 2

Answer 6

moderate
50%<FEV1<80%

Question 7

grade 3

Answer 7

severe
30%<FEV1<50%

Question 8

grade 4

Answer 8

very severe
<30%

Question 9

grade 1

Answer 9

only breathless with strenuous exercise

Question 10

grade 1

Answer 10

short of breath when hurting on the level or walking up a slight hill

Question 11

grade 2

Answer 11

walk slower than people of the same age on the level because of breathlessness or have to stop for breath when walking on my own pace on the level

Question 12

grade 3

Answer 12

stop for breath after walking about100 meters or after a few minutes on the level

Question 13

grade 4

Answer 13

too breathlessness to leave the house or am breathlessness when dressing or undressing

Question 14

vaccines

Answer 14

flu
covid
pneumonia
RSV
Tdap
zoster

Question 15

nonpharm

Answer 15

long term oxygen
if resting PaO2 <55 or O2 saturation <88%
goal Pao2 >60 or O2 saturation >90%

Question 16

initial pharm treatment