COPD

Question 1

This disease is caused by 1 or combination of these disorders which causes airway ________ and ________?

Answer 1

Emphysema, asthma, chronic bronchitis. Limitations and obstructions

Question 2

All structures of the acinar are affected by this type of emphysema and is caused by?

Answer 2

Panacinar, alpha-1 antitrypsin deficiency

Question 3

This type of emphysema affects respiratory bronchioles is is caused by?

Answer 3

Centriacinar, cigarette smoking, coal mining

Question 4

The decrease in expiratory airflow in COPD is caused by?

Answer 4

elasticity of the lungs

Question 5

Is defined by productive cough that last 3 months and occurs two years in a row?

Answer 5

Chronic bronchitis

Question 6

These are two hallmarks of COPD?

Answer 6

inflammation and partially or non-reversible airflow obstruction

Question 7

Clinical manifestations of COPD?

Answer 7

Dyspnea, cough, sputum production, weight gain or loss, decreased sexual activity, cough syncope, depression or anxiety

Question 8

Single best indicator of COPD?

Answer 8

decline in FEV1

Question 9

Physical exam findings of severe COPD?

Answer 9

Barrel chest, prolonged expiratory phase, accessory muscle recruitment, wheezing and rhonchi, cyanosis

Question 10

Diagnostic testing for COPD?

Answer 10

pulse ox, chest xray, PFT, CT of lungs

Question 11

FEV1/FVC indicator of COPD?

Question 12

CXR findings for COPD?

Answer 12

Hyperinflation, flattened diaphragms, decreased vascular markings

Question 13

Options for smoking cessation?

Answer 13

Varenicline (Chantix), wellbutrin, nortriptyline, nicoderm CQ, habitrol patches

Question 14

Dosing for Varenicline (Chantix)

Answer 14

Initial dose: 0.5mg x 3 days, 0.5mg BID x 4 days, 1g BID x 11 weeks

Question 15

Side effects of Varenicline

Answer 15

GI distress, headache, vivid dreams, suicidal thoughts and depression

Question 16

Treatment of stable COPD

Answer 16

bronchodilators (beta agonist, anticholinergics) ICS

Question 17

Short acting bronchodilators (beta agonist)

Answer 17

Albuterol and levalbuterol

Question 18

Anticholinergics

Answer 18

Ipratropium (atrovent) short acting. Titotropium (spiriva) or Aclinidium (tudorza) long acting

Question 19

long acting beta-2 agonist

Answer 19

Salmeterol (Serevent), Formoterol (foradil)

Question 20

ICS are used with these medications and should not be taken as?

Answer 20

LABA or anticholinergic. Should not be taken as monotherapy

Question 21

ICS

Answer 21

Beclomethasone (Qvar), budesonide (pilmicort), fluticasone (flovent), mometasone (Asmanex)

Question 22

Combination ICS + LABA?

Answer 22

Budesonide + Formoterol (Symbicort), Flucticasone + Salmeterol (Advair), Vilanterol + Fluticasone (breo ellipta)

Question 23

This medication can be added onto triple combination thereapy for refractory disease?

Answer 23

low dose theophylline. not use alot in the US. levels need monitored due to toxicity

Question 24

Oral medication that decreased airway inflammation?

Answer 24

PDE-4 inhibitors (phosphodiesterase 4 inhibitor)

Question 25

Percent on PFT that indicates COPD?

Answer 25

70%