COPD

Question 1

COPDer

Answer 1

Corticosteroids (inhaled- mild COPD, oral (prednisone)- severe COPD, IV (methylprednisolone)- exacerbation)
Oxygen (SpO2 < 88; PaO2 < 55); note: scale back during chronic setting- otherwise hypoxemic respiratory drive will be stunted
Prevention (vaccines (flu, streptococcal) and smoking cessation)
Dilators (short acting (albuterol, tiotroprium), long acting (LAMAntagonist, LABA), and oral (theophylline))
Experimental (not working)
Rehab

*Decrease mortality

Question 2

S&S

Answer 2

Wheezing
Cough
Sputum production

Chest X-ray, ABG, and ECG can help with differentiate from other things; but for diagnosis requires PFTs (FEV1/FVC)

Question 3

Antibiotics

Answer 3

Doxycycline, azithromycin

Question 4

Bronchodilators

Answer 4

Albuterol

Ipratroprium

Question 5

Steroids

Answer 5

PO: Prednisone
IV: Methylprednisone

Question 6

Treatment

Answer 6

SABA
\+LAMA
\+LABA
\+ICS
\+PDE4 inhibitors
\+steroids

Question 7

Acute exacerbation treatment

Answer 7

O2
Alb/ Ipratropium
Steroids

With treatment
If better: Home (gets PO steroids and metered dose inhalers)

If same/ more time: Wards (gets PO steroids, nebulizers)

If worse: ICU (increased CO2, absence of lung sounds)
gets IV steroids, neb, BIPAP, and ET tube