COPD Flashcards
Major physiologic change in COPD. (Harrison’s 19th edition, pp 1700)
Airflow limitation
Centriacinar or Panacinar?
Most frequently associated with cigarette smoking. (Harrison’s 19th edition, pp 1701)
Centriacinar
Centriacinar or Panacinar?
Predilection for the lower lobes. (Harrison’s 19th edition, pp 1701)
Panacinar
Centriacinar or Panacinar?
Characterized by enlarged air spaces found (initially) in association with respiratory bronchioles. (Harrison’s 19th edition, pp 1701)
Centriacinar
Centriacinar or Panacinar?
Focal. (Harrison’s 19th edition, pp 1701)
Centriacinar
Centriacinar or Panacinar?
Refers to abnormally large airspaces evenly distributed within and across acinar units. (Harrison’s 19th edition, pp 1701)
Panacinar
Centriacinar or Panacinar?
Prominent in the upper lobes and superior segments of lower lobes. (Harrison’s 19th edition, pp 1701)
Centriacinar
Centriacinar or Panacinar?
Observed in patients with a1AT deficiency. (Harrison’s 19th edition, pp 1701)
Panacinar
Panacinar emphysema. (Harrison’s 19th edition, pp 1701)
Refers to abnormally large airspaces evenly distributed within and across acinar units
Observed in patients with a1AT deficiency
Predilection for the lower lobes
Centriacinar emphysema. (Harrison’s 19th edition, pp 1701)
Most frequently associated with cigarette smoking
Characterized by enlarged air spaces found (initially) in association with respiratory bronchioles
Focal
Prominent in the upper lobes and superior segments of lower lobes
GOLD stage II. (Harrison’s 19th edition, pp 1704)
Moderate
FEV1/FVC < 0.7 and FEV1 >/= 50% but <80% predicted
GOLD stage IV. (Harrison’s 19th edition, pp 1704)
Very severe
FEV1/FVC < 0.7 and FEV1 < 30% predicted
GOLD stage I. (Harrison’s 19th edition, pp 1704)
Mild
FEV1/FVC < 0.7 and FEV1 >/= 80% predicted
GOLD stage III. (Harrison’s 19th edition, pp 1704)
Severe
FEV1/FVC < 0.7 and FEV1 >/= 30% but <50% predicted
Recommended treatment for Combined assessment of GOLD class A. (GOLD Guidelines)
SA anticholinergic prn or SA beta-2 agonist prn
Recommended treatment for Combined assessment of GOLD class B. (GOLD Guidelines)
LA anticholinergic or LA beta-2 agonist
Recommended treatment for Combined assessment of GOLD class C. (GOLD Guidelines)
ICS +
LA beta-2 agonist or LA anticholinergic
Recommended treatment for Combined assessment of GOLD class D. (GOLD Guidelines)
ICS +
LA beta-2 agonist and/or LA anticholinergic
Most highly significant predictor of FEV1 in COPD. (Harrison’s 19th edition, pp 1702)
Pack-years of cigarrete smoking
Only pharmacologic therapy demonstrated to unequivocally decrease mortality rates in patients with COPD. (Harrison’s 19th edition, pp 1706)
Supplemental oxygen
Treatment of COPD that has been demonstrated to improve health-related quality of life, dyspnea and exercise capacity, and reduce rates of hospitalization over a 6-12 month period. (Harrison’s 19th edition, pp 1706)
Pulmonary rehabilation
The major site of increased resistance in individuals with COPD. (Harrison’s 19th edition, pp 1701)
Small airways < or = 2mm diameter
The definitive test to diagnose emphysema. (Harrison’s 19th edition, pp 1705)
CT scan
Most typical finding in COPD. (Harrison’s 19th edition, pp 1701)
Persistent reduction in forced expiratory flow rates
In COPD, inhaled bronchodilators will produce improvement of up to how many percent? (Harrison’s 19th edition, pp 1701)
15%
Pathophysiology of COPD. (Harrison’s 19th edition, pp 1701)
Airflow limitation/obstruction
Hyperinflation (Increases in the residual volume and the residual volume/total lung capacity ratio)
Nonuniform distribution of ventilation
Ventilation-perfusion mismatching
Disease state characterized by airflow limitation that is not fully reversible. (Harrison’s 19th edition, pp 1700)
Chronic Obstructive Pulmonary Disease (COPD)
An anatomically defined condition characterized by destruction and enlargement of the lung alveoli. (Harrison’s 19th edition, pp 1700)
Emphysema
A clinically defined condition with chronic cough and phlegm. (Harrison’s 19th edition, pp 1700)
Chronic Bronchitis
A condition in which small bronchioles are narrowed. (Harrison’s 19th edition, pp 1700)
Small airways disease
Hallmark of COPD. (Harrison’s 19th edition, pp 1704)
Airflow obstruction
In gas exchange of COPD, PaO2 usually remains near normal until FEV1 is decreased to ____ of predicted. (Harrison’s 19th edition, pp 1702)
~50%
In gas exchange of COPD, elevated PaCO2 is not expected until FEV1 is ______ of predicted. (Harrison’s 19th edition, pp 1702)
< 25%
Often results in mucous gland enlargement and goblet cell hyperplasia leading to cough and mucus production. (Harrison’s 19th edition, pp 1701)
Cigarette smoking
Bronchi undergo __________ predisposing to carcinogenesis and disrupting mucociliary clearance. (Harrison’s 19th edition, pp 1701)
Squamous metaplasia
Offers both a mortality benefit and a symptomatic benefit in certain patients with emphysema as demonstrated in the National Emphysema Treatment Trial. (Harrison’s 19th edition, pp 1706)
Lung Volume Reduction Surgery (LVRS)
