COPD Flashcards
What is COPD?
An obstructive pulmonary disease, characterized by airflow limitation that is not fully reversible, and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases
What is the difference between COPD and asthma?
Asthma is reversible
What percent of the US population has COPD?
6.3%
What is the typical COPD pt?
65+ poor white woman that smokes
What are the risk factors for COPD?
Cigarette smoking
Occupational exposures
Air pollution
What are the three characteristics of the small airway disease underlying COPD?
Airway inflammation
Airway fibrosis
Increased resistance
Parenchymal destruction in COPD results in what two major effects?
- Loss of alveolar attachments
- Decrease of elastic recoil
What is the definition of chronic bronchitis?
Productive cough that occurs everyday for at least 3 months, two years in a row
What are the three COPD subsets?
Chronic bronchitis
Emphysema
Asthma
What are the ssx of COPD? How fast is the onset?
- Productive cough
- DOE
- progressive symptoms
What are the physical findings late in the course of COPD? (3)
- Using accessory muscles at rest
- Increased AP diameter
- Heart failure
What happens with FEV1 and FEV1/FVC with COPD patients?
Decreased FEV1, and lower FEV1/FVC (less than 0.7)
What are the four steps of assessing COPD?
- Assess symptoms
- Assess severity by spirometry
- Exacerbations
- Comorbidities
Is the cough associated with COPD usually productive?
No, but may be variable from day-to-day
What are the characteristics of dyspnea with COPD?
Progressive, worse with exercise
What are the post bronchodilator FEV1 percentages for mild, moderate, severe, and very severe COPD?
mild = more than 80%
moderate = 50-80%
severe = 30-50%
Very severe = less than 30%
What happens to the flow-volume loop with obstructive lung disease?
Indentation of the curve
What are the two main predictors of exacerbation risk for a patient with COPD?
- Two or more exacerbations within the last year, or
- an FEV1 less than 50%
True or false: any hospitalization for COPD exacerbations should be considered a high risk pt
True
What are the comorbidities with COPD?
- CV disease
- Osteoporosis
- Respiratory infections
- DM
- Lung CA
- Bronchiectasis
What is bronchiectasis?
Chronic inflammation of the airway leading to fibrotic changes, and impaired mucus clearance
What are the two main goals of therapy for COPD?
Relieve ssx
Reduce risk
What is the single most important intervention for COPD?
Smoking cessation
How much faster do your lungs age with smoking?
x2
True or false: there is still benefit of smoking cessation at age 65
True