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Pulmonology > COPD > Flashcards

COPD Flashcards

1
Q

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

A

COPD

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2
Q

COPD includes the following characteristics: (Harrison pp 1700)

A

Emphysema
Chronic Bronchitis
Small airway disease

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3
Q

Major physiologic changes with COPD (Harrison pp 1700)

A

Airflow limitation

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4
Q

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

A

Cigarette smoking
Inflammation
Structural cell death
Ineffective repair of elastin

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5
Q

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

A

Elastase: antielastase hypothesis

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6
Q

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

A

Neutrophil elastase
Matrix metalloproteinases
Serine proteinases

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7
Q

Most potent secretagagues identified (Harrison pp 1701)

A

Neutrophil elastase

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8
Q

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

A

Emphysema

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9
Q

Centroacinar emphysema (Harrison pp 1701)

A

Cigarette smoking
Upper lobes and Superior segments of lower lobes
Focal

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10
Q

Panancinar emphysema (Harrison pp 1701)

A

Acinar units

Alpha1 AT deficiency

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11
Q

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

A

Macrophage

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12
Q

Most typical pathophysiology findings of COPD (Harrison pp 1701)

A

↓ Forced Expiratory Flow Rates

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13
Q

Pathophysiology of COPD (Harrison pp 1701)

A

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

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14
Q

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

A

FEV <50%

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15
Q

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

A

FEV <25%

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16
Q

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

A

Cigarette smoking

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17
Q

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

A

Dutch Hypothesis

18
Q

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

A

Airway hyperresponsiveness

19
Q

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

A

Biomass combustion

20
Q

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

A

PiZ

21
Q

3 most common symptoms in COPD (Harrison pp 1704)

A

Cough
Sputum production
Exertional dyspnea

22
Q

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

A

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

23
Q

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

A

S ternocledomastoid
I ntercostal muscle
S calene

24
Q

Pink puffers (Harrison pp 1704)

A

Emphysema

Thin and Acyanotic

25
Q

Blue bloaters (Harrison pp 1704)

A

Heavy and Cyanotic

26
Q

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

A

Wasting

27
Q

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

A

Hoover’s Sign

28
Q

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

A

Degree of airflow obstruction

29
Q

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

A

Moderate (GOLD II)

30
Q

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

A

Severe (GOLD III)

31
Q

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

A

Small airways (≤ 2mm diameter)

32
Q

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

A

CT Scan

33
Q

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

A

Smoking cessation
O2 therapy
Lung volume reduction surgery

34
Q

Alternative treatment for smoking cessation (Harrison pp 1705)

A

Nicotine replacement therapy
Bupropion
Varenidine

35
Q

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

A

Tiotropium

36
Q

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

A

Theophylline

37
Q

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

A

Supplemental Oxygen

38
Q

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

A

True

39
Q

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)

A

Pulmonary rehabilitation

40
Q

Contraindicated for lung volume reduction surgery (Harrison pp 1706)

A 
Pleural disease
Pulmonary artery systolic pressure >45 mmHg
Extreme deconditioning 
Congestive Heart Failure
FEV1 < 20%
Diffusely distributed emphysema
41
Q

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

A

History of prior exacerbations

42
Q

Bacterial associated with COPD (Harrison pp 1707)

A

Haemophilus influenzae
Moraxella catarrhalis
Streptococcus pneumoniae

Pulmonology (9 decks)

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