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RTH 121 > COPD test questions > Flashcards

COPD test questions Flashcards

1
Q

VT

A

Normal or increase

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2
Q

IRV

A

Normal or decrease

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3
Q

ERV

A

Normal or decrease

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4
Q

RV

A

Increase

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5
Q

VC

A

Decrease

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6
Q

IC

A

Normal or decrease

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7
Q

FRC

A

Increase

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8
Q

TLC

A

Normal or increase

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9
Q

RV/TLC ratio

A

Normal or increase

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10
Q

What emphysema is genetic or inherited?

A

Panlobular

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11
Q

What emphysema results from cigarette smoking?

A

Centrilobular

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12
Q

_____ is a preventable and treatable disease state characterized by airflow limitation that is not fully _____.

A

COPD; reversible

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13
Q

_____ 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.

A

Chronic bronchitis

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14
Q

____ 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.

A

Emphysema

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15
Q

What is based on the major “clinical manifestations” associated with the disease?

A

Chronic bronchitis

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16
Q

What is based on the pathology, or the “anatomic alterations of the lung,” associated with the disorder?

A

Emphysema

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17
Q

_____ 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.

A

COPD

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18
Q

What are some anatomic alterations of the lungs associated with chronic bronchitis?

A

Chronic inflammation, excessive mucus, mucus plugging, bronchospasm, hyperinflation/air trapping

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19
Q

What are some anatomic alterations of the lungs associated with emphysema?

A

Permanent enlargement, destruction of pulmonary capillaries, weakening of the distal airways, hyperinflation/air trapping

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20
Q

What are some considered risk factors for COPD?

A

Tobacco smoke, occupational dusts and chemicals, indoor/outdoor air pollution, conditions that affect normal lung grow and genetic predisposition (AAT deficiency)

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21
Q

What are the key indicators for considering a COPD diagnosis?

A

Dyspnea, chronic cough, chronic sputum production, history of exposure to risk factors

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22
Q

What are the 3 main spirometry tests for COPD?

A

FVC, FEV1, FEV1/FVC ratio

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23
Q

The presence of COPD is confirmed with both the ____ and ____ are decreased

A

FEV1; FEV1/FVC ratio

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24
Q

Stage I COPD

A

Mild; FEV1>=80%

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25
Q

Stage II COPD

A

Moderate; FEV1 50% to <80% of predicted and patient often complains of shortness of breath upon exertion

26
Q

Stage III COPD

A

Severe; FEV1 30% to 50% impacts the quality of life

27
Q

Stage IV COPD

A

Very severe; FEV1 <50% of predicted, plus chronic respiratory failure

28
Q

Emphysema patients show a _____ body build and _____ where chronic bronchitis patients are ______.

A

Thin and barrel chest; stocky/overweight

29
Q

Emphysema patients tend to have respiratory patterns like ________ where as chronic bronchitis patients tend to have respiratory patterns like _____

A

Hyperventilation; hypoventilation

30
Q

Emphysema patients demonstrate ______ breathing while chronic bronchitis patients have a ____ and _____.

A

Pursed lip; cough and sputum

31
Q

Emphysema patients have _____ skin while chronic bronchitis patients show signs of ______, ______ and _______.

A

Reddish; cyanosis, peripheral edema and neck vein distention

32
Q

______ patients tend to use their accessory muscles when breathing

A

Emphysema

33
Q

______ 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

A

Emphysema; chronic bronchitis

34
Q

On a chest radiograph, _____ has hyperinflation, narrow mediastinum, normal or small vertical heart, low flat diaphragm and presence of blebs or bullae

A

Emphysema

35
Q

On a chest radiograph, ____ has congested lung fields, densities, increased bronchial vascular markings, and an enlarged horizontal heart

A

Chronic bronchitis

36
Q

Infections and polycythemia are commonly found in ____ patients

A

Chronic bronchitis

37
Q

A decrease in DLco and DLco/VA is commonly found in ____ patients

A

Emphysema

38
Q

What disease is associated with pulmonary hypertension and cor pulmonale?

A

Chronic bronchitis

39
Q

Altered sensorium such as anxiety and irritability are often found in _____ patients

A

Emphysema (severe stage) and chronic bronchitis (moderate and severe stage)

40
Q

Digital clubbing is often found in ____ patients

A

Late stage emphysema and chronic bronchitis

41
Q

Hoover’s sign is associated with what disease?

A

Emphysema (severe stage)

42
Q

Upon palpation of the chest, decreased tactile fremitus, decreased chest expansion and PMI shifts to the epigastric area is often signs of what?

A

Emphysema

43
Q

What is a normal ABG for a CO2 retained at equilibrium?

A 
pH 7.38
SpO2 88-90
PaCO2 60
PaO2 58
HCO3 34
44
Q

What are the ABG results for acute alveolar hyperinflation superimposed on chronic ventilatory failure?

A

pH 7.48
PaCO2 48
PaO2 38
HCO3 34

45
Q

_____ 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

A

Bronchiectasis

46
Q

What blood gas changes are associated with bronchiectasis?

A

Respiratory alkalosis with hypoxemia (acute alveolar hyperinflation) or in severe cases respiratory acidosis with hypoxemia (chronic alveolar hypoinflation)

47
Q

_____ and ______ decrease in pulmonary function studies of bronchiectasis

A

Airflows and vital capacity

48
Q

What feature favors the diagnosis of COPD?

A

Chronic daily phlegm production

49
Q

Cough, phlegm production, wheezing and shortness of breath are common signs and symptoms of _____

A

COPD

50
Q

What are the four clinical goals for managing stable COPD?

A
  • Establish diagnosis
  • Prolong survival
  • Simplify medical regimen
  • Optimize lung function
  • Maximize patient’s functional status
51
Q

Both _____ and _____ bronchodilators can improve airflow in patients with COPD

A

Anticholinergic and adrenergic

52
Q

Other treatment options to maximize lung function include administering _____ and methylxanthines

A

Corticosteroids

53
Q

Systemic corticosteroids can produce significant improvements in airflow in _____ of patients with stable COPD

A

6%-29%

54
Q

Controlled trials do show lessened dyspnea in _____ recipients despite lack of measurable increases in airflow

A

Methylxanthines

55
Q

To minimize the chance of toxicity, current recommendations suggest maintaining serum theophylline levels at _____

A

8-10 mcg/ml

56
Q

What can be done to prevent the progression of COPD?

A

Cessation of smoking

57
Q

What therapy has been proven to prolong the survival of COPD patients?

A

Supplemental oxygen

58
Q

PaO2 <= 55mmHg, PaO2 56-59mmHg or SaO2 89% signifies the need for _____

A

Continuous oxygen therapy

59
Q

What are two surgeries that can be used in extreme cases for patient’s with end stage COPD?

A

Lung transplantation or lung volume reduction surgery (LVRS)

60
Q

Can all patients benefit from LVRS?

A

No, patients with severe COPD should not get it

61
Q

___ of patients can be expected to live for five years after receiving a lung transplant surgery

A

54%

RTH 121 (9 decks)

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