Diseases in Pulmonary Medicine: COPD Flashcards
Components of COPD
Emphysema, chronic bronchitis
Pathogenesis behind emphysema
Imbalance between protease (elastase) and anti-protease (alpha-1-anti-trypsin)
First symptom of emphysema
Dyspnea
Most highly significant predictor of FEV1
Pack years of cigarette smoking
Important cause of exacerbations of COPD
Respiratory infections
Most common form of severe A1-antitrypsin deficiency
PiZ
Most typical finding in COPD
Persistent reduction in forced expiratory flow rates
Accounts for essentially all of the reduction in PaO2 that occurs in COPD
Ventilation-perfusion mismatching
Major site of increased resistance in most individuals with COPD
Small airways (
Type of emphysema most frequently associated with cigarette smoking
Centriacinar emphysema (Sentroacinar, Smoking)
Type of emphysema usually observed in patients with alpha-1-AT deficiency
Panacinar emphysema
Type of emphysema associated with spontaneous pneumothorax
Distal acinar emphysema
Major physiologic change in COPD resulting from both small airway obstruction and emphysema
Airflow limitation
Three most common symptoms of COPD
Cough, chronic sputum production, exertional dyspnea
The only pharmacologic therapy demonstrated to unequivocally decrease mortality rates
Supplemental oxygen
Strong predictor of future exacerbations
History of prior exacerbations
Bacteria frequently implicated in COPD exacerbations
Streptococcus pneumonia
Haemophilus influenza
Moraxella catarrhalis
Only three interventions demonstrated to influence the natural history of patients with COPD
Smoking cessation
Oxygen therapy in chronically hypoxemic patients
Lung volume reduction surgery in selected patients
