COPD Flashcards

1
Q

Anatomically/histologically permanent and destructive enlargement of airspaces distal to the terminal bronchioles WITHOUT obvious fibrosis yet with loss of normal architecture

A

Emphysema

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2
Q

Productive cough not attributable to other causes on most days for

at least 3 MONTHS over 2 CONSECUTIVE YEARS

A

Chronic Bronchitis

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3
Q

Affected in small airway disease

A

Small bronchioles are narrowed

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4
Q

Major site of increased resistance in most individuals with COPD

A

Small airways

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5
Q

Emphysema pathologic types

A

Centriacinar: respiratory bronchioles
Panacinar: large spaces

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6
Q

Emphysema more frequent with cigarette smoking

A

Centriacinar

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7
Q

Prominent locations of centriacinar emphysema

A

Upper lobes

Superior segments of lower lobes

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8
Q

Emphysema usually observed a1AT deficiency

A

Panacinar

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9
Q

Predilection of panacinar emphysema

A

Lower lobes

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10
Q

Most typical finding in COPD

A

Persistent reduction in forced expiratory flow rates

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11
Q

Found late in the course of COPD

A

(+) air trapping and hyperinflation

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12
Q

May cause severe pulmonary hypertension causing cor pulmonale and RV failure

A

Decreased FEV1 (<25% of predicted + chronic hypoxemia PaO2 <55mmHg)

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13
Q

Cause of reduction of PaO2 in COPD

A

VQ mismatch

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14
Q

Risk factor for mortality from chronic bronchitis and emphysema

A

Cigarette smoking

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15
Q

Risk factor for COPD and a significant predictor of subsequent decline in pulmonary function

A

AHR

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16
Q

PROVEN genetic factor for COPD

A

Severe a1 antitrypsin (a1AT) deficiency

17
Q

3 MC complaints in COPD

A

cough
sputum production
exertional dyspnea

18
Q

“Pink puffers”

A

Predominantly emphysema

19
Q

“Blue bloaters”

A

Predominantly chronic bronchitis

20
Q

Independent poor prognostic factor in COPD

21
Q

Paradoxical inward movement of the rib cage with inspiration

A

Hoover’s sign

22
Q

RV failure signs

A
Inc JVP
RV heave or S3
Hepatic congestion
Ascites
Peripheral edema
23
Q

Gold standard for COPD diagnosis

A

Pulmonary function testing

24
Q

Hallmark of COPD

A

airflow obstruction

PFT with Decreased FEV1 and FEV1/FVC

25
Confirms presence of airflow obstruction
FEV1/FVC ratio <70% + postbronchodilator FEV1 <80% predicted
26
Decreased DLCO
Emphysema (due to parenchymal destruction characteristic of the disease)
27
Most important sign of severe exacerbation in patients with very severe COPD
Mental status changes
28
Only pharmacologic therapy demonstrated to unequivocally decrease mortality rates in COPD
O2 therapy
29
Bacteria frequently implicated in exacerbations
Streptococcus pneumoniae Haemophilus influenzae Moraxella catarrhalis