COPD test questions Flashcards
VT
Normal or increase
IRV
Normal or decrease
ERV
Normal or decrease
RV
Increase
VC
Decrease
IC
Normal or decrease
FRC
Increase
TLC
Normal or increase
RV/TLC ratio
Normal or increase
What emphysema is genetic or inherited?
Panlobular
What emphysema results from cigarette smoking?
Centrilobular
_____ is a preventable and treatable disease state characterized by airflow limitation that is not fully _____.
COPD; reversible
_____ is defined clinically as a chronic productive cough for 3 months in each of 2 successive years in a patient in whom other causes of productive chronic cough have been excluded.
Chronic bronchitis
____ is defined pathologically as the presence of permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.
Emphysema
What is based on the major “clinical manifestations” associated with the disease?
Chronic bronchitis
What is based on the pathology, or the “anatomic alterations of the lung,” associated with the disorder?
Emphysema
_____ is a preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.
COPD
What are some anatomic alterations of the lungs associated with chronic bronchitis?
Chronic inflammation, excessive mucus, mucus plugging, bronchospasm, hyperinflation/air trapping
What are some anatomic alterations of the lungs associated with emphysema?
Permanent enlargement, destruction of pulmonary capillaries, weakening of the distal airways, hyperinflation/air trapping
What are some considered risk factors for COPD?
Tobacco smoke, occupational dusts and chemicals, indoor/outdoor air pollution, conditions that affect normal lung grow and genetic predisposition (AAT deficiency)
What are the key indicators for considering a COPD diagnosis?
Dyspnea, chronic cough, chronic sputum production, history of exposure to risk factors
What are the 3 main spirometry tests for COPD?
FVC, FEV1, FEV1/FVC ratio
The presence of COPD is confirmed with both the ____ and ____ are decreased
FEV1; FEV1/FVC ratio
Stage I COPD
Mild; FEV1>=80%
Stage II COPD
Moderate; FEV1 50% to <80% of predicted and patient often complains of shortness of breath upon exertion
Stage III COPD
Severe; FEV1 30% to 50% impacts the quality of life
Stage IV COPD
Very severe; FEV1 <50% of predicted, plus chronic respiratory failure
Emphysema patients show a _____ body build and _____ where chronic bronchitis patients are ______.
Thin and barrel chest; stocky/overweight
Emphysema patients tend to have respiratory patterns like ________ where as chronic bronchitis patients tend to have respiratory patterns like _____
Hyperventilation; hypoventilation
Emphysema patients demonstrate ______ breathing while chronic bronchitis patients have a ____ and _____.
Pursed lip; cough and sputum
Emphysema patients have _____ skin while chronic bronchitis patients show signs of ______, ______ and _______.
Reddish; cyanosis, peripheral edema and neck vein distention
______ patients tend to use their accessory muscles when breathing
Emphysema
______ has decreased breath/heart sounds, prolonged expiration, decreased diaphragmatic excursion and hyperresonance while ______ has wheezes, crackles and rhonchi depending on the severity of the disease
Emphysema; chronic bronchitis
On a chest radiograph, _____ has hyperinflation, narrow mediastinum, normal or small vertical heart, low flat diaphragm and presence of blebs or bullae
Emphysema
On a chest radiograph, ____ has congested lung fields, densities, increased bronchial vascular markings, and an enlarged horizontal heart
Chronic bronchitis
Infections and polycythemia are commonly found in ____ patients
Chronic bronchitis
A decrease in DLco and DLco/VA is commonly found in ____ patients
Emphysema
What disease is associated with pulmonary hypertension and cor pulmonale?
Chronic bronchitis
Altered sensorium such as anxiety and irritability are often found in _____ patients
Emphysema (severe stage) and chronic bronchitis (moderate and severe stage)
Digital clubbing is often found in ____ patients
Late stage emphysema and chronic bronchitis
Hoover’s sign is associated with what disease?
Emphysema (severe stage)
Upon palpation of the chest, decreased tactile fremitus, decreased chest expansion and PMI shifts to the epigastric area is often signs of what?
Emphysema
What is a normal ABG for a CO2 retained at equilibrium?
pH 7.38 SpO2 88-90 PaCO2 60 PaO2 58 HCO3 34
What are the ABG results for acute alveolar hyperinflation superimposed on chronic ventilatory failure?
pH 7.48
PaCO2 48
PaO2 38
HCO3 34
_____ is the dilation of the bronchi and bronchioles, which is chronic in nature and results in inflammation and damage to the walls of these airways
Bronchiectasis
What blood gas changes are associated with bronchiectasis?
Respiratory alkalosis with hypoxemia (acute alveolar hyperinflation) or in severe cases respiratory acidosis with hypoxemia (chronic alveolar hypoinflation)
_____ and ______ decrease in pulmonary function studies of bronchiectasis
Airflows and vital capacity
What feature favors the diagnosis of COPD?
Chronic daily phlegm production
Cough, phlegm production, wheezing and shortness of breath are common signs and symptoms of _____
COPD
What are the four clinical goals for managing stable COPD?
- Establish diagnosis
- Prolong survival
- Simplify medical regimen
- Optimize lung function
- Maximize patient’s functional status
Both _____ and _____ bronchodilators can improve airflow in patients with COPD
Anticholinergic and adrenergic
Other treatment options to maximize lung function include administering _____ and methylxanthines
Corticosteroids
Systemic corticosteroids can produce significant improvements in airflow in _____ of patients with stable COPD
6%-29%
Controlled trials do show lessened dyspnea in _____ recipients despite lack of measurable increases in airflow
Methylxanthines
To minimize the chance of toxicity, current recommendations suggest maintaining serum theophylline levels at _____
8-10 mcg/ml
What can be done to prevent the progression of COPD?
Cessation of smoking
What therapy has been proven to prolong the survival of COPD patients?
Supplemental oxygen
PaO2 <= 55mmHg, PaO2 56-59mmHg or SaO2 89% signifies the need for _____
Continuous oxygen therapy
What are two surgeries that can be used in extreme cases for patient’s with end stage COPD?
Lung transplantation or lung volume reduction surgery (LVRS)
Can all patients benefit from LVRS?
No, patients with severe COPD should not get it
___ of patients can be expected to live for five years after receiving a lung transplant surgery
54%
