COPD/Emphysema Flashcards
What two diseases does COPD include?
Chronic bronchitis and emphysema
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 188.
What is a potential adverse side effect of diuretic
therapy to treat cor pulmonale in patients with severe
COPD?
What is a potential adverse side effect of diuretic
therapy to treat cor pulmonale in patients with severe
COPD?
What is the difference between chronic bronchitis
and emphysema?
Chronic bronchitis is characterized by obstruction of small
airways and emphysema consists of enlargement of the air
sacs, destruction of the lung parenchyma, loss of pulmonary
tissue elasticity, and closure of the small airways.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 188
What are the primary symptoms associated with
COPD?
Chronic productive cough and progressive exercise limitation.
In advanced disease, orthopnea and dyspnea during activities
of daily living may develop.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 188.
What is asthmatic bronchitis?
Asthmatic bronchitis is the combination of chronic bronchitis
with reversible bronchospasm.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 188-189.
How are pulmonary function tests affected by COPD?
The FEV1/FVC is decreased, but the FEV25-75 is decreased
the most. The total lung capacity (TLC), residual volume (RV),
and functional residual capacity (FRC) are all normal or
increased.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 190.
What chest x-ray findings are consistent with COPD?
Often, the chest x-ray doesn’t reveal many changes, but if the
disease is severe enough, there may be hyperlucency due to
vascular deficiency in the lung periphery. Hyperinflation of the
lungs may be seen as the diaphragm loses its curved
appearance and becomes flat.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 189.
How does the hematocrit differ between patients with
chronic bronchitis and emphysema?
The hematocrit is elevated in patients with chronic bronchitis
and normal in patients with emphysema.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 189.
How does smoking cessation affect the progression
of COPD?
Smoking cessation can diminish or even completely eradicate
the symptoms of chronic bronchitis and halts the progressive
decline in lung function seen in patients who continue to smoke.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 190.
What is the most effective therapy for treating
increased pulmonary vascular resistance and
erythrocytosis seen with COPD?
Chronic oxygen therapy, which is indicated for a PaO2 less than
55 mmHg or a hematocrit greater than 55%.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 190.
Gas exchange occurs in the airways across which
type of cells?
The mucosa in the airway gradually transitions from ciliated
columnar epithelium to cuboidal epithelium and finally to flat
alveolar epithelium where gas exchange occurs.
Butterworth JF, Mackey DC, Wasnick JD. Morgan & Mikhail’s
Clinical Anesthesiology. 5th ed. New York, NY: McGraw-Hill;
2013: 489.
What pulmonary function tests are indicative of a
high risk for pulmonary complications from surgery?
FEV1
What are the preoperative strategies that should be
employed to reduce the risk of postoperative
pulmonary complications in COPD patients?
Cease smoking for at least 6 weeks prior to surgery, treat any
existing airflow obstruction, treat respiratory infections with
antibiotics, teach the patient lung expansion techniques to use
postoperatively.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 192-193.
How is the duration of surgery related to the
development of postoperative pulmonary
complications in COPD patients?
Surgeries lasting 2.5 hours or more are associated with a higher
risk of pulmonary complications in these patients.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 191.
What is the role of regional anesthesia for patients
with COPD undergoing surgery?
The use of regional anesthesia as the primary anesthetic is
associated with a reduced risk of pulmonary complications
when compared to general anesthesia and it should be
employed whenever possible. The use of regional anesthesia
for postoperative analgesia is also helpful because the
increased pain control promotes greater lung expansion and
earlier extubation.
Hines RL, Marschall KE. Anesthesia & Co-Existing Diseases.
6th ed. Philadelphia, PA: Elsevier-Saunders; 2012: 193.
