COPD vs Asthma

Question 1

What is a wheeze

Answer 1

continuous, coarse, whistling sound produced in the respiratory airways during breathing. Some part of the respiratory tree must be narrowed or obstructed

Question 2

How does a COPD patient present

Answer 2

Pack year hx of smoking, persistent dyspnea, cough, sputum

Question 3

How does asthma typically present

Answer 3

atopy, allergic rhinitis, intermittent cough and a wheeze

Question 4

what features does asthma have

Answer 4

wheezing, breathlessness, chest tightness, night time/early morning coughing

Question 5

what are the 3 cardinal features of asthma

Answer 5

variability, PRECIPATANTS, reversibility

Question 6

Is asthma familial

Answer 6

Yes

Question 7

Allergic asthma has what cells involved

Answer 7

eosinophils, mast cells, IgE

Question 8

what tests can be used to diagnose asthma

Answer 8

simple peak flow, vitalograph, spirometry

Question 9

what do you normally want to see on spirometry

Answer 9

Rapid upstroke and a long expiration

Question 10

How does COPD present

Answer 10

hypoxia because of emphysema (blue bloaters) and then chronic coughing and mucus production because of chronic bronchitis (pink puffers)

Question 10

what is COPD

Answer 10

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

Question 11

What is classified as a significant bronchodilator response on spirometry

Answer 11

20% improvement in peak flow or 12% and 200ml improvement in FEV1

Question 12

Does asthma or COPD show more of bronchodilator response

Answer 12

asthma

Question 13

Are steroids used early or late in COPD guidelines

Answer 13

Late

Question 14

what are advantages of inhaled therapy

Answer 14

targets site of disease, lower dose, limited systemic absorption, fewer side effects, rapid onset

Question 15

what are the goals for asthma therapy

Answer 15

symptom control and risk reduction (minimize risk of future exacerbations)

Question 16

what type of medications are more commonly used for COPD but should never be used alone in asthma

Answer 16

LABA

Question 17

what are the goals for COPD therapy

Answer 17

limit disease progression by stopping smoking

Improve lung mechanics by treating symptoms

prevent exacerbations by treating critical periods of symptomatic deterioration

Improve quality of life and function by rehab

Question 18

what are the key elements of COPD therapy

Answer 18

education
reduce symptoms by relieving symptoms and improving exercise tolerance
reducing risk by preventing disease progression

Question 19

what are the non-pharmacological treatments for COPD

Answer 19

smoking cessation
promote healthy lifestyle
vaccination
treat comorbidities

Question 20

what vaccinations reduces risk of copd

Answer 20

influenza and pneumococcal

Question 21

what drugs should be given to patients who can keep up with their friends (MMRC<2)

Answer 21

short acting beta-2 agonist or anticholinergic

Question 22

what drugs must you give to patients who cannot keep up with their friends (MMRC>3)

Answer 22

LABA or long acting muscarinic antagonist

Question 23

Why are COPD patients typically older

Answer 23

You need a significant pack year hx of smoking

Question 24

How does asthma and copd differ in terms of persistent symptoms

Answer 24

Asthma has variation and COPD is continous

Question 25

How does asthma and copd differ in terms of worsening of symptoms

Answer 25

asthma is seasonal and it is triggered by emotions and other exposures and nocturnal whilst COPD has a progressive course

Question 26

what are the primary treatment options for COPD

Answer 26

bronchodilators

Question 27

Typical spirometry stracing

Answer 27