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Patho > COPD > Flashcards

COPD Flashcards

1
Q

Is it true that COPD is mainly underdiagnosed?

A

True

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2
Q

What percentage of people diagnosed with COPD are smokers?

A

15-20%

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3
Q

What genes play a role in the etiology of COPD?

A

TNF, surfactant, proteases and antiproteases

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4
Q

Inherited mutation in alpha-1 _ gene leads to _ deficiency

A

antitrypsin; AAT

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5
Q

True or false: Impairment of fetal development resulting in low birthweight is a predisposing factor to COPD

A

True

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6
Q

True or false: Infants who develop bronchopulmonary dysplasia are susceptible to developing COPD

A

True

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7
Q

What are the 3 COPD phenotypes?

A

Chronic bronchitis, emphysema, bronchiectasis

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8
Q

What phenotype is characterized by airway inflammation and obstruction of the major and small airways?

A

chronic bronchitis

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9
Q

What phenotype has a productive cough for at least 3 consecutive months over 2 years to be diagnosed?

A

chronic bronchitis

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10
Q

What phenotype is characterized by loss of lung elasticity and abnormal enlargement of the airspaces distal to the terminal bronchioles with destruction of the alveolar walls and capillary beds?

A

Emphysema

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11
Q

What is bronchiectasis?

A

Permanent dilation of the bronchi and bronchioles due to destruction of the muscle and elastic supporting tissue

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12
Q

T/F: Sinitus is a commonly seen in past medical Hx of patients with COPD

A

False

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13
Q

T/F: acute eosinophilic inflammation is seen within the bronchioles in COPD

A

False, this type of inflammation is seen in asthma

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14
Q

What is the chronic obstruction of the airways due to inflammation and irreversibility characteristics of?

A

COPD

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15
Q

T/F: The pathologic changes of COPD include squamous metaplasia of epithelium, parenchymal destruction, mucus gland metaplasia and enlargement

A

True

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16
Q

T/F: The pathologic changes of COPD include fragile epithelium, thickening of basement membrane, mucus gland metaplasia and enlargement

A

False; this is true of asthma

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17
Q

What causes the loss of lung elastic recoil in COPD?

A

The proteases mediate degradation of connective tissue elements in the lungs

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18
Q

_fibrosis is caused by the imbalance of the lungs repair and defense mechanisms

A

Peribronchiolar

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19
Q

What is the key factor in developing irreversible airflow limitation seen in COPD?

A

Fibrosis of the small airways leading to remodeling

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20
Q

Inflammation and _ injury play a role in mucus hypersecretion

A

oxidant

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21
Q

Increased tone n airway SM due to _ of the bronchi with _ due to persistent _

A

hyperactivity, bronchoconstriction, inflammation

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22
Q

“blue bloaters” is a term used for_

A

chronic bronchitis

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23
Q

Which phenotype would you expect to see cyanosis and edema in the abdomen and legs?

A

chronic bronchitis

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24
Q

When would you expect to see ciliary function impaired?

A

chronic bronchitis

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25
Q

Why does the body increase RBC production in chronic bronchitis?

A

In hopes to try and oxygenate the blood but the blood just gets thicker increasing pulmonary pressure

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26
Q

What phenotype of COPD is known as “pink puffers”

A

Emphysema

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27
Q

The breakdown of _ in the alveolar septa and bronchial walls by _ is seen in _

A

elastin, proteases, emphysema

28
Q

Alpha-1 antitrypsin deficiency is seen in _

A

emphysema

29
Q

Proteases are released from _, alveolar macrophages and other inflammatory cells

A

neutrophils

30
Q

_destruction destroys portions of the pulmonary capillary bed leading to ventilation and perfusion mismatch leading to hypoxemia

A

septal

31
Q

Decreased _ in bronchial walls leads to _ that leads to hyperinflation

A

elastic recoil, air trapping

32
Q

_ is the most common site/ type of emphysema

A

centriacinar

33
Q

Why is barrel chest more commonly associated more with emphysema than chronic bronchitis?

A

Due to the air trapping

34
Q

Which type of immunity is more associated with all stages of COPD?

A

innate

35
Q

which type of immunity is mainly seen in severe cases?

A

adaptive

36
Q

_-_increases expression of adhesion molecules on leukocytes on leukocytes and endothelial cells and upregulates other pro-inflammatory cytokines.

A

TNF-alpha

37
Q

_-_is associated with COPD associated weight loss

A

TNF-alpha

38
Q

- is the link between the adaptive and innate immune systems and stimulates C-reactive protein release from the liver

A

IL-6

39
Q

- is linked with disease severity

A

IL-32

40
Q

_ plays a key role in dendritic cell programming by stimulating specific chemokines which then attract T helper lymphocytes and cytotoxic T lymphocytes

A

TSLP

41
Q

COPD is _ inflammatory disease in which lungs are one form of expression

A

systemic

42
Q

Cytokines associated with _ involvement:IL-6, TNF-alpha, IL-8, IL-1Beta

A

muscle

43
Q

Leptin is important in regulating _ and is _ in people with COPD

A

energy, decreased

44
Q

_ is a significant predictor of BMI

A

CRP

45
Q

An increase in _ is correlated with an increase in exacerbations

A

serum amyloid A

46
Q

What would we expect to see in the CBC of a patient with AECOPD?

A

elevated leukocytes, anemia, elevated cytokines and acute phase proteins

47
Q

When reviewing chest x-ray report, _ and _ is consistent with air trapping

A

hyperinflation and flattening of the hemidiaphragms

48
Q

_ is the standard assessment tool for dx, staging and monitoring of COPD

A

Spirometry

49
Q

FEV _ indicates more advanced disease

A

<80%

50
Q

FCV is not always _ during early stages of COPD

A

decreased

51
Q

FEV/FVC post-bronchodilator _ confirms airflow limitation

A

<0.70

52
Q

In what stage and case of COPD do we administer O2 therapy to the patient

A

Usually in stage 4, in very severe disease with chronic respiratory therapy

53
Q

Long term therapy of O2 can be used during _ or prn to relieve episodes or acute_

A

exercise; dyspnea

54
Q

Which type of therapy for COPD improves pulmonary hypertension, increases exercise capability and lung function, improves the mental and emotional states, increases survival in persons with chronic respiratory failure

A

O2 therapy

55
Q

_therapy is considered during severe exacerbations or in persons with chronic hypercapnia respiratory failure

A

NIPPV (noninvasive positive pressure ventilation)

56
Q

Inhaled _ decrease bronchoconstriction by reducing muscle tone and glandular mucus

A

anticholinergics

57
Q

Inhaled_ recommended for the long-term prevention and reductions of COPD symptoms

A

Beta-2 adrenergic agonists (LABAS)

58
Q

_ are negligible as a monotherapy for COPD

A

corticosteroids

59
Q

_ is used as a third line of therapy

A

methylxanthines

60
Q

_ reduces symptoms (specifically improves dyspnea, exercise endurance), improves QoL, increase physical and emotional participation of ADLs, decreased risk of hospitalization following AECOPD

A

Pulmonary Rehabilitation

61
Q

The goal of _ is to restore a patient to the fullest medical, emotional, social and vocational status possible

A

Pulmonary rehabilitation

62
Q

What are the 3 components of pulmonary rehab?

A
  1. exercise training (aerobic and resistance)
  2. nutritional coaching
  3. patient education
63
Q

_ is the most common cause of AECOPD

A

Infection

64
Q

Pharmacology for COPD is aimed at _

A

Improving airflow

65
Q

Smoking cessation for patients with COPD is the only intervention to slow the rate of _

A

lung function decline

Patho (4 decks)

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