COPD

Question 1

Smoker reduction in FEV1

Answer 1

40ml/year

Question 2

Alpha 1 antitrypsin deficiency

Answer 2

COPD
LFT abnormalities
cirrhosis

Question 3

empheysema

Answer 3

enlargement of air spaces with destruction of alveolar walls

Question 4

centriacinar

Answer 4

respiratory bronchioles distal to terminal bronchiole, remainder of acinus sparred
smoking

Question 5

panacinar

Answer 5

alveolar ducts
adjacent alveoli
coalescence and bullae
alpha 1 antitrypsin deficiency

Question 6

sites of airway obstuction

Answer 6

distal airways of less then 2mm

Question 7

PE

Answer 7

distant heart sounds
diminished breath sounds
pedal edema
distended jugular vv
hepatic congestion
cachexia

Question 8

Mild

Answer 8

FEC1/FVC < 70%

FEC1 >=80% predicted

Question 9

moderate

Answer 9

FEC1/FVC < 70%

FEV1 50-80% predicted

Question 10

severe

Answer 10

FEC1/FVC < 70%

FEV1 30-50% predicted

Question 11

very severe

Answer 11

FEC1/FVC < 70%

FEV1 30-50%, with chronic respiratory failure

Question 12

Rx

Answer 12

beta adrenergic agonists- inhaled
anticholingerics- inhaled
methylxanthines
phosphodiesterase-4 inhibitors
corticosteriods

Question 13

short acting beta 2 agonists

Answer 13

albuterol

levalbuterol

Question 14

long acting beta 2 agonists

Answer 14

salmeterol

formoterol

Question 15

short acting anticholinergics

Answer 15

ipatropium bromide

Question 16

long acting anticholinergics

Answer 16

tiotropium

Question 17

methylantines

Answer 17

thophylline oral
antagonizes adenosine Rs, increased cAMP, weak bronchodilator, close monitoring, narrow therapeutic window, numerous side effects and drug interactions

Question 18

phosphodiesterase 4 inhibitor

Answer 18

roflumilast

Question 19

corticosteroids

Answer 19

when inhaled reduces COPD exacerbations and added benefit when combined w/long acting beta agonist
systemic has not been shown to help and has lots of side effects

Question 20

immunizations

Answer 20

influenza

penumococcus

Question 21

bacterial infections

Answer 21

H. influenza
S. penumoniae
M. catarrhalis
less common- psudomonas and enteric bacilli

Question 22

viral infections

Answer 22

rhino
influenza
RSV