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Pulmonology > COPD > Flashcards

COPD Flashcards

1
Q

What is COPD?

A

Airflow limitation that is not fully reversible.

Limitation is usually progressive and associated with abn inflammatory response to noxious particles

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2
Q

What populations have higher prevalence of COPD?

A 
Age 65-74
Non-Hispanic White
Women
Low income 
Current or former smokers
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3
Q

What are the risk factors of COPD

A 
Cigarette Smoke
Occ dust and chemicals 
Envt tobacco smoke
Indoor and outdoor air pollution
Genes 
Infections 
Socioeconomic status
Aging pop.
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4
Q

What are the mechanisms of COPD?

A 
SMall airway Disease
-airway inflammation
-airway fibrosis, luminal plugs
-inc airway resistance
Parenchymal Destruction
-loss of alveolar attachments 
-decrease of elastic recoil

ALL LEAD to Airflow limitation

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5
Q

What is Chronic Bronchitis?

A

Cough that occurs every day with Sputum production that lasts for at least 3 months, two years in a row

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6
Q

What is the clinical presentation of COPD?

A 
>60yo
Productive cough
Dyspnea on exertion 
Progressive symptoms
Risk factors 
Later in disease:
-Accesory Muscles at rest
-increased AP diameter 
-Right Heart Failure
Weight loss
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7
Q

What are the spirometry findings in COPD?

A

It takes much longer to reach plateau (complete Exhalation)

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8
Q

What are the steps of COPD Assesment?

A

Assess Symptoms
Assess Degree of Airflow limitation with spirometry
Assess risk of exacerbations
Assess comorbidities

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9
Q

What are the symptoms of COPD?

A

Dyspnia
Chronic Cough
Chronic Sputum Production

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10
Q

What is used to Assess risk of Exacerbation of COPD?

A

2 or more exacerbations within the last year OR FEV1 of

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11
Q

What are the COPD Comorbidities?

A 
Cardiovascular Diseases 
Osteoporosis
Resp infections 
Anxiety and Depression
Diabetes
Lung Cancer
Bronchiectasis
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12
Q

What are the goals of COPD Therapy?

A 
Reduce Symptoms
-improve exercise tolerance
-improve health status
Reduce Risk
-prevent disease progression
-prevent and treat exacerbations
-reduce mortaity
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13
Q

What are the drugs used in COPD?

A 
Beta agonists 
-Albuterol
-Salbutamol
-Levabuterol
-Metaproterenol
Anticholinergic
-Impratropium Bromide
Long acting Beta Agonists (LABA)
Long acting Muscarinic Agents (LAMA)
Inhaled Corticosteroids
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14
Q

What is a possible danger of using Theophylline?

A

Very narrow theraputic index and has multiple factors that influence its metabolism

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15
Q

When are inhaled Corticosteroids Used?

A

In combo with LABA or LAMA
GOLD stage III or IV with significant symptoms or recurrent exacerbations
(earlier if asthma present)

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16
Q

Why are systemic Stroids not used for COPD?

A

Chronic Conitnuous Use associated with Increased Morbidity and Mortality

17
Q

What are the criteria for Oxygen therapy?

A

pO2

18
Q

What are the signs of Acute COPD Exacerbation?

A 
Mental Status Changes
Single word speaking
Silent Chest
Hemodynamic Instability
Labored Breathing, Paradoxical Breathing
19
Q

What are ancillary tests to do in a COPD Exacerbation?

A 
ABG
CXR
Oximetry Monitoring
EKG
CBC, Chem 7
20
Q

What is the Outpatient management of COPD Exacerbation?

A 
Course of systemic Steroids
Inc Dose of Short acting bronchodilators 
Use of Atbx if purulent sputum
-Doxycycline, TMP/SMX
-Azithromycin, Quinolones
21
Q

What is Inpatient Management of COPD Exacerbation? How do you know who needs to be admitted?

A 
Failure of outPt mangt
Dyspnia at rest
Evidence of Tachypnia
Use of accessory muscles to breathe at rest
Tachycardia
Hypoxemia
22
Q

Why do want to avoid overoxygenating a Pt with Severe COPD?

A

You will decrease perfusion to the oxygenated portions of the lung by getting overall vasodilation to whole lung. You’ll overcome the normal Hypoxia driven vasoconstriction. You will increase functional Dead Space.

23
Q

Which Patients should be given antibiotics in COPD?

A

Cardinal Symptoms

Require Mechanical Ventilation

Pulmonology (18 decks)

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