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IPFC 2 Final > COPD Pathophys > Flashcards

COPD Pathophys Flashcards

1
Q

COPD prevalence in

35-55yo men or women
60-85yo+ men or women

A

35-55yo women
60-85yo+ men

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2
Q

is COPD underdiagnosed or overdiagnosed? In which type of GOLD patients is the most?

A

Underdiagnosed GOLD 1

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3
Q

Are death rates increasing in women or men?

A

Women

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4
Q

T/F COPD is the greatest hospitalization cause

A

True

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5
Q

Where are the abnormalities in COPD patients? What is it caused by?

A

Abnormalities at Bronchi/alveoli
- caused by exposure of noxious particles or gases

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6
Q

What are 2 common conditions that COPD encompasses as an umbrella term?

A
  • Chronic bronchitis (bronchioles
  • Emphysema (stiff alveoli)
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7
Q

What are factors that influence development and progression of COPD (8)

A
  1. Exposure to toxins/pollutants
  2. Genetics (alpha-1-antitrypsin deficiency)
    - protects lungs against neutropil elastase
  3. Lung growth and development
  4. Age and female sex
  5. Socioeconomic status
  6. Asthma
    - hyper-reactivity of airways –> can lead to COPD with irritant exposure over time
  7. Chronic bronchitis (can inc. risk of exacerbations)
  8. Infections (severe childhood respiratory infections)
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8
Q

What are the mechanisms that lead to COPD (2)

A
  1. Small airway disease
    - Decreased FEV1
  2. Parenchymal destruction
    - Decreased gas transfer
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9
Q

How does COPD develop? what are the steps (4)

A
  1. Inhalation of noxious particles
  2. Modified lung inflammation
  3. Parenchymal tissue destruction
  4. Gas trapping and progressive airflow limitation
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10
Q

What is pathogenesis causes of COPD (5)

A
  1. Increased oxidant stress
    - from irritants/inflammatory cells = lung damage
  2. Protease/antiprotease imbalance
    - less antiprotease –> less protection of connective tissue
    - more proteases –> more breakdown of connective
  3. Inflammatory cells
    - inc macrophages, neutrophils, lymphocytes
    - inc eosinophils especially in asthma patients
  4. Inflammatory mediators
    - attract more inflammatory cells
  5. Peribronchiolar and interstitial fibrosis
    - muscle and fibrous tissue
    - contributes to small airways limitation and EMPHYSEMA
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11
Q

What are the most common symptoms of COPD (3)

A
  1. Dyspnea
  2. Cough
  3. Sputum production
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12
Q

What is the pathophysiology of COPD? (

A
  1. Airflow limitation/ air trapping
    - relieved by bronchodilators
  2. Gas exchange abnormalities
    - hypoxemia (low O2), hypercapnia (high CO2)
  3. Mucus hypersecretion
    - increased goblet cells due to airway irritation
    - chronic productive cough
  4. Pulmonary hypertension
    - low O2 levels –> pulmonary arteries thicken
  5. Exacerbations
  6. Systemic features
    - heart disease/failure, osteoporosis, anemia, diabetes, metabolic syndrome, depression
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13
Q

Is COPD reversible? Does it have a good response to steroids?

A

Not fully reversible (small bronchodilator response)
- poor response to steroids

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14
Q

Compare COPD and asthma
Onset in life
Persistent/Fluctuation
Cause

A

Onset
COPD: mid-life
Asthma: early-life

COPD: Persistant
Asthma: Fluctuation

Cause
COPD: History of exposure to irritants
Asthma: Presence of allergy, rhinitis, eczema

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15
Q

When should you consider COPD in patients

A

With any main symptoms:
- dyspnea
- chronic cough
- sputum production

and/OR
- a history of exposure to risk factors

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16
Q

What spirometry value confirms airflow limitation and COPD?

A

FEV1/FVC ratio UNDER 0.70

FEV1 based on post-bronchodilator

17
Q

Can chronic cough be unproductive in COPD

A

No

18
Q

What do history of risk factors look like? (4)

A
  • Tobacco smoke
  • Occupational dusts/chemicals
  • Smoke from home cooking/heating fuels
  • Host factors
19
Q

Define the following classification of severity of
GOLD 1
- Clinical features
- Spirometry values (FEV1, FEV1/FVC)

A

GOLD 1:

Clinical features
- may have chronic cough/sputum production (not always)
- patient usually unaware that lung function is abnormal

Spirometry
- FEV1/FVC: under 0.70
- FEV1: 80%+

20
Q

Define the following classification of severity of
GOLD 2
- Clinical features
- Spirometry values (FEV1, FEV1/FVC)

A

GOLD 2:

Clinical features
- SOB develops on exertion (exercise, long walks)
- Cough and sputum production sometimes present
- Stage where they seek medical attention

Spirometry
- FEV1/FVC: under 0.70
- FEV1: 50-80%

21
Q

Define the following classification of severity of
GOLD 3
- Clinical features
- Spirometry values (FEV1, FEV1/FVC)

A

GOLD 3:

Clinical features
- Greater SOB
- Repeated exacerbations that impact QoL

Spirometry
- FEV1/FVC: under 0.70
- FEV1: 30-50%

22
Q

Define the following classification of severity of
GOLD 4
- Clinical features
- Spirometry values (FEV1, FEV1/FVC)

A

GOLD 4:

Clinical features
- chronic respiratory failure
- Have symptoms of right ventricle failure
- exacerbations life-threatening

Spirometry
- FEV1/FVC: under 0.70
- FEV1: under 30%

IPFC 2 Final (6 decks)

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