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Pulmonary > COPD > Flashcards

COPD Flashcards

1
Q

what happens in COPD

A

bronchial walls break, can no longer perform gas exchange

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2
Q

main cells of inflammation in COPD

A

neutrophils, caused by noxious agent

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3
Q

pink puffer is seen w/

A

emphysema

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4
Q

chronic bronchitis critera

A

productive cough for 3 months in each of 2 successive eyars

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5
Q

blue bloater is seen w/

A

chronic bronchitis

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6
Q

main risk factors for COPD

A
  • smoking
  • alpha 1 antirtrypsin deficiency
  • HIV
  • low birth weight
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7
Q

how does alpha 1 antitrypsin work

A

produced by liver, reaches alveolar lining, binds to extra elastase that is used to kill bacteria to neutralize it
deficiency causes emphysema, specifically lower lobe

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8
Q

TLC is max b/w 25-27 years, after this how many CCs of air are lost normally per year? how much for smokers?

A

25cc

75 cc

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9
Q

how is COPD diagnosed

A

spirometry

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10
Q

radiographic findings of COPD

A
  • low, flattened diaphragm

- increased AP diameter

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11
Q

what is the best marker of mortality for COPD?

A

FEV1

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12
Q

what happens with cigarette smokers

A

dopamine released in nucleus accumens, give artificial nicotine

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13
Q

tx of cigarette replacement

A

varenicline tartrate, increases dopamine

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14
Q

therapy for stable COPD

A
  • smoking cessation (group A)
  • pulmonary rehab( A/B)
  • flu/pneumococcal vaccine
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15
Q

COPD meds for group

A

SAMA (short acting muscarinic antagonist-vasodilation)

SABA (short acting beta agonist)

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16
Q

phosphodiesterase inhibitors are used for

A

group D pts, roflumilast

17
Q

common LABA drugs

A

salmeterol, formoterol, olodaterol

18
Q

common anticholinergic (SAMA/LAMA)

A

short acting-ipratropium bromide (atrovent)

long acting-tiotropium bromide (spiriva), aclinidium (tudorza)

19
Q

common LAMA/LABA combo meds

A

umeclidinium/vilantgerol (anoro, ellipta)
tiotropium/olodaterol (stiolto, respimat)
glycopyrronium/formoterol

20
Q

when to use glucocorticosteroids

A
  • if FEV1<50% predicted and repeated exacerbations

- does not modify long term decline in FEV1, but does reduce freq of exacerbations and improve health status

21
Q

Group A tx

A

bronchodilator

use SAMA if pt has heart disease

22
Q

Group B tx

A

LAMA first or LABA

23
Q

Group C tx

A

LAMA and LABA plus ICS

24
Q

Group D tx

A

LAMA, LABA, ICS,forlumilast if FEV1<50% pred and pt has chronic bronchitis

25
Q

adverse effects of inhaled steroids

A
  • pneumonia

- thrush

26
Q

systemic effects of COPD

A
  • abnormal oxidative metabolism
  • reduced skeletal muscle mass and function
  • reduced lean body mass
27
Q

when is long term O2 required?

A

when P02 <60

28
Q

common pathologic organisms

A

H influenza
S pneumoniae
M catarrhalis

29
Q

COPD presents w/

A
  • cough

- slight sputum

Pulmonary (7 decks)

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