COPD 3 - Mx

Question 1

Stable COPD

• refer to resp specialist if diagnostic ? or ? COPD
• pt education - how to early recognise an ?, make an action plan/? meds for freq exacerbations -> ? for incr breathlessness, ABx for incr/changing ?
• lifestyle advice - diet, ? (to own level), and most importantly ? ?
• meds - level of inhaled meds depends on ?

Answer 1

uncertainty
deteriorating
exacerbation
rescue
steroids
sputum
exercise
smx cessation
fev1

Question 2

Stable COPD medication
everyone -> ? (may cont with at all stages) or a ? as required

step up if ? or ? breathlessness
FEV1 >50%…
-add ? or ? - with this one must discontinue SAMA

FEV1<50%…
-?+? in a combo inhaler, or a ? (discontinue SAMA)
if combo not tolerated/declined consider giving LABA+?)

Answer 2

SABA
SAMA

exacerbations
persistent

LABA
LABA

LABA+ICS
LAMA
LAMA

Question 3

If after these meds there is still exacerbations or persistent breathlessness -> if were on SABA+LABA now add ?, or consider adding ? if this not tolerated.

After this all patients can keep using their ? along with triple therapy of ?, ?+? in a combo inhaler

Answer 3

ICS
LAMA

SABA
LAMA, LABA+ICS

Question 4

Specialist treatments

• pulm ? - consider if ? ? by COPD, shown to incr ? capacity, decr ? and improve ???, ? sessions per week for ? weeks, elements of ?, ? and ? training
• ? aminophylline/theophylline - consider if stable pt is still ? after a trial of ? therapy (or cannot use ?)
• ? - consider in stable pts with chronic prod cough
• nutritional supplementation - consider for those with ? ?

Answer 4

rehab
fx disabled
exercise
SOB
QOL
3
6
behavioural
educational
physical
oral
Sxatic
triple
inhalers
mucolytics
low BMI

Question 5

LTOT
assess for LTOT if pt sats % on air, FEV1 % predicted, cyanosed, secondary ? or ? ?
must be assessed while at their ? - can’t be done if at ? for an ?
must be warned not to ?
this incr survival if used for >?h/day -> 3y survival incr by over ?%

Answer 5

92
30
polycythaemia
cor pulm
best
hosp
exacerbation
smx
15
50

Question 6

Surgery

• ? for recurrent pneumothoraces
• ? for ? bullous disease
• lung ? ? surgery - removal of diseased tissue allows functioning lung to ?

Answer 6

pleurectomy
bullectomy
vol reduction
expand