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Physiology > COPD > Flashcards

COPD Flashcards

1
Q

Characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities caused by significant exposure to noxious particles or gases

A

COPD

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2
Q

Persistent respiratory symptoms and airflow limitations that is NOT fully reversible

A

Chronic Obstructive Pulmonary Disease (COPD)

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3
Q

Major physiologic change in COPD

A

airflow limitation

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4
Q

3 MC symptoms in COPD

A

cough
sputum production
exertional dyspnea

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5
Q

A PROVEN GENETIC RISK FACTOR for COPD

A

α1AT deficiency

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6
Q

Associated with MARKEDLY REDUCED Α1AT LEVEL

A

Z allele

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7
Q

Individuals with two Z alleles or one Z and one null allele and the MC form of severe α1AT deficiency

A

PiZ

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8
Q

Changes in LARGE AIRWAYS will give rise to

A

cough and sputum

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9
Q

Changes in small airways ≤2 mm and alveoli

A

physiologic alterations

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10
Q

Reduction of this can↑ surface tension at the air-tissue interface –> airway narrowing or collapse

A

Surfactant

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11
Q

Cells that will undergo biological pathways of PROTEASE-ANTIPROTEASE IMBALANCE  ECM DESTRUCTION

A

Macrophages

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12
Q

Cells that will undergo biological pathways of OXIDANT/ANTIOXIDANT IMBALANCE –> CHRONIC INFLAMMATION

A

Neutrophils

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13
Q

Cells that will undergo biological pathways of APOPTOSIS –> CELL DEATH

A

Epithelial Cells

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14
Q

Cells that will undergo biological pathways of LUNG REPAIR –> INEFFECTIVE REPAIR

A

Lymphocytes

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15
Q

Paradoxical inward movement of the rib cage with inspiration and a result of chronic hyperinflation

A

Hoover sign

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16
Q

Hallmark of COPD

A

airflow obstruction

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17
Q

Radiographic findings in COPD

EMPHYSEMA

A

obvious bullae
paucity of parenchymal markings
hyperlucency

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18
Q

The current definitive test for establishing the presence or absence of emphysema, the pattern of emphysema, and the presence of significant disease involving medium and large airways

A

Chest computed tomography (CT) scan

19
Q

The STRONGEST SINGLE PREDICTOR OF EXACERBATIONS

A

history of a previous exacerbation

20
Q

Pink puffers

A

emphysema

thin, non-cyanotic, prominent use of accessory muscles

21
Q

Blue bloaters

A

chronic bronchitis

heavy and cyanotic

22
Q

Signs of hyperinflation

A

barrel chest

hyperresonance on percussion

23
Q

Severe cases - signs of cor pulmonale

A

bipedal edema

ascites

24
Q

Spirometry

A

FEV1/FVC <0.70
REDUCED FEV1, FEC1/FVC
INCREASED TLC, FRC and RV (d.t. air trapping)

25
Q

GOLD 1

FEV1 > 80% predicted

A

MILD

chronic cough and sputum production

patient unaware that lung function is abnormal

26
Q

GOLD 2

FEV1 50 - <80% predicted

A

MODERATE

chronic cough and sputum production

SOB on exertion

patients seek medical attention

27
Q

GOLD 3

FEV 1 30 - <50 % predicted

A

SEVERE

greater SOB
reduced exercise capacity
fatigue
repeated exacerbations

28
Q

GOLD 4

FEV 1 < 30 % predicted

A

VERY SEVERE

signs and symptoms of respiratory failure (PaO2 <60 mmHg +/- PaCO2 > 50 mmHg)

cor pulmonale

29
Q

Most prominent in the UPPER lobes and SUPERIOR segments of lower lobes

most frequently associated with CIGARETTE SMOKING

A

Centriacinar emphysema

30
Q

Abnormally large air spaces evenly distributed within and across acinar units

α1AT deficiency

has a predilection for the LOWER lobes

A

Panacinar emphysema

31
Q

abnormally large air spaces evenly distributed w/n and across acinar unit

significant airway inflammation and w/ centrilobular emphysema

A

Paraseptal emphysema

32
Q

Clinically defined condition with chronic cough and phlegm

A

CHRONIC BRONCHITIS

33
Q

Major site of ↑ resistance

A

SMALL AIRWAYS

34
Q

Characteristic of COPD

A

Non-uniform ventilation and V/Q mismatching

35
Q

The current DEFINITIVE TEST for establishing the presence or absence of emphysema

A

computed tomography (CT) scan

36
Q

3 INTERVENTIONS WHICH IMPROVE SURVIVAL OF PATIENTS W/ COPD

A

smoking cessation

oxygen therapy in chronically hypoxemic patients

lung volume reduction surgery in selected patients with emphysema

37
Q

PHARMACOLOGIC APPROACHES FOR SUCCESSFUL SMOKING CESSATION:

A
  • bupropion
  • nicotine replacement therapy available as gum, transdermal patch, lozenge, inhaler, and nasal spray
  • Varenicline - a nicotinic acid receptor agonist/antagonist
38
Q

Used for symptomatic benefit in patients with COPD

A

Bronchodilators

inhaled route – preferred

39
Q

improves symptoms and produces acute improvement in FEV1

A

Ipratropium bromide

40
Q

Beta Agonists

A

SABA – ease symptoms w/ acute improvement in lung function

LABA – symptomatic benefit and reduce exacerbations

tremor and tachycardia – main side effects

41
Q

Inhaled Glucocorticoids

A

reduce exacerbations

S.E.

oropharyngeal candidiasis, pneumonia and loss of bone density

42
Q

Reduce exacerbation frequency in patients w/ severe COPD, chronic bronchitis and prior history of exacerbations

A

Roflumilast

43
Q

The only pharmacologic therapy demonstrated to unequivocally decrease mortality rates in patients with COPD

A

Supplemental Oxygen

Physiology (98 decks)

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