COPD

Question 1

Airflow limitation that is not fully reversible (Harrison pp 1700)

Answer 1

COPD

Question 2

COPD includes the following characteristics: (Harrison pp 1700)

Answer 2

Emphysema
Chronic Bronchitis
Small airway disease

Question 3

Major physiologic changes with COPD (Harrison pp 1700)

Answer 3

Airflow limitation

Question 4

4 intercalated events in the pathogenesis of emphysema (Harrison pp 1700)

Answer 4

Cigarette smoking
Inflammation
Structural cell death
Ineffective repair of elastin

Question 5

Balance of elastin degrading enzymes and their inhibitors determines the susceptibility of the lung to destruction (Harrison pp 1700)

Answer 5

Elastase: antielastase hypothesis

Question 6

What are the macrophage elastase involved? (Harrison pp 1701)

Answer 6

Neutrophil elastase
Matrix metalloproteinases
Serine proteinases

Question 7

Most potent secretagagues identified (Harrison pp 1701)

Answer 7

Neutrophil elastase

Question 8

Destruction and enlargement of the lung alveoli (Harrison pp 1700)

Answer 8

Emphysema

Question 9

Centroacinar emphysema (Harrison pp 1701)

Answer 9

Cigarette smoking
Upper lobes and Superior segments of lower lobes
Focal

Question 10

Panancinar emphysema (Harrison pp 1701)

Answer 10

Acinar units

Alpha1 AT deficiency

Question 11

What accumulate in respiratory bronchioles of essentially ALL YOUNG SMOKERS? (Harrison pp 1701)

Answer 11

Macrophage

Question 12

Most typical pathophysiology findings of COPD (Harrison pp 1701)

Answer 12

↓ Forced Expiratory Flow Rates

Question 13

Pathophysiology of COPD (Harrison pp 1701)

Answer 13

Î Residual volumes
Î Residual lung/total lung capacity ratio
Nonuniform distribution of ventilation
Ventilation-perfusion mismatching

Question 14

How much FEV1 is decreased to manifest/affect the O2? (Harrison pp 1702)

Answer 14

FEV <50%

Question 15

How much FEV1 is decreased to manifest/affect the pCo2? (Harrison pp 1702)

Answer 15

FEV <25%

Question 16

It is most highly significant predictor FEV1 (Harrison pp 1702)

Answer 16

Cigarette smoking

Question 17

Asthma, chronic bronchitis and emphysema are all same entities (Harrison pp 1702)

Answer 17

Dutch Hypothesis

Question 18

It is consider as a risk factor for COPD (Harrison pp 1703)

Answer 18

Airway hyperresponsiveness

Question 19

Common mode of cooking in some countries (Harrison pp 1703)

Answer 19

Biomass combustion

Question 20

Most common form of severe alpha1 AT deficiency (Harrison pp 1703)

Answer 20

PiZ

Question 21

3 most common symptoms in COPD (Harrison pp 1704)

Answer 21

Cough
Sputum production
Exertional dyspnea

Question 22

In advance COPD, what is the principal feature? (Harrison pp 1704)

Answer 22

Worsening dyspnea on exertion with increasing intrusion on the ability to perform vocational or avocational activities

Question 23

In tripod position, what muscles are involved? (Harrison pp 1704)

Answer 23

S ternocledomastoid
I ntercostal muscle
S calene

Question 24

Pink puffers (Harrison pp 1704)

Answer 24

Emphysema

Thin and Acyanotic

Question 25

Blue bloaters (Harrison pp 1704)

Answer 25

Heavy and Cyanotic

Question 26

It is an independent POOR prognostic factor in COPD (Harrison pp 1704)

Answer 26

Wasting

Question 27

Paradoxical inward movement of rib cage with inspiration (Harrison pp 1704)

Answer 27

Hoover's Sign

Question 28

It is an important prognostic factor in COPD (Harrison pp 1704)

Answer 28

Degree of airflow obstruction

Question 29

FEV1/FVC <0.7 and FEV1 ≥ 50% but <80% (Harrison pp 1704)

Answer 29

Moderate (GOLD II)

Question 30

FEV1/FVC <0.7 and FEV1 ≥30% but <50% (Harrison pp 1704)

Answer 30

Severe (GOLD III)

Question 31

Major site of increased resistance in most individuals of COPD (Harrison pp 1701)

Answer 31

Small airways (≤ 2mm diameter)

Question 32

Definitive test for establishing the presence or absence of emphysema in living subjects (Harrison pp 1705)

Answer 32

CT Scan

Question 33

In stable phase of COPD, only three interventions have demonstrated to influence the natural history of patient with COPD (Harrison pp 1705)

Answer 33

Smoking cessation O2 therapy Lung volume reduction surgery

Question 34

Alternative treatment for smoking cessation (Harrison pp 1705)

Answer 34

Nicotine replacement therapy Bupropion Varenidine

Question 35

Long acting anticholinergic that have shown for improvement symptoms and reduce exacerbations (Harrison pp 1705)

Answer 35

Tiotropium

Question 36

It produces modest improvements in expiratory flow rates and vital capacity (Harrison pp 1706)

Answer 36

Theophylline

Question 37

It is the only pharmacologic therapy demonstrated to unequivocally decrease mortality rates in patient with COPD (Harrison pp 1706)

Answer 37

Supplemental Oxygen

Question 38

COPD patients should receive the influenza vaccine annually (Harrison pp 1706) True or False

Answer 38

True

Question 39

It has demonstrated to improve health-related quality of life, dyspnea and exercise capacity Reduce rates of hospitalization over 6 to 12 months period (Harrison pp 1706)

Answer 39

Pulmonary rehabilitation

Question 40

Contraindicated for lung volume reduction surgery (Harrison pp 1706)

Answer 40

``` Pleural disease Pulmonary artery systolic pressure >45 mmHg Extreme deconditioning Congestive Heart Failure FEV1 < 20% Diffusely distributed emphysema ```

Question 41

What is the strong predictor of future exacerbations? (Harrison pp 1706)

Answer 41

History of prior exacerbations

Question 42

Bacterial associated with COPD (Harrison pp 1707)

Answer 42

Haemophilus influenzae Moraxella catarrhalis Streptococcus pneumoniae