Lecture 12 COPD Flashcards
COPD:
____ decreases dramatically;
FVC _____;
What happens to the ratio?
FEV1; decreases;
Ratio decreases
Is COPD due to obstruction of inflow or obstruction of outflow?
outflow
Bronchitis vs Emphysema: patients are overweight and cyanotic = patients are older and thin = Peripheral edema is common = Increased AP diameter of chest =
bronchitis (blue bloater);
emphysema (pink puffer);
bronchitis;
emphysema
COPD:
____ lose their shape and become clogged with mucus;
walls of ____ are destroyed.
bronchioles;
alveoli
bronchitis vs emphysema: enlargement of air spaces = loss of elastic recoil = hyperplasia of mucus secreting glands = barrel shaped chest =
emph;
emph;
bronch;
emph
90% of patients with COPD are ____
smokers
what is required to establish diagnosis of COPD?
spirometry
What spirometric finding tells you how severe the COPD is?
FEV1; ie more decreased FEV1 = more severe disease
COPD vs asthma:
which is reversible?
persistent and productive cough seen in =
asthma;
COPD
what genetic deficiency should be screened for in patients with COPD of a young age?
alpha 1 antitrypsin
CXR of patient with COPD shows a ____ diaphragm
flattened
most important therapeutic option in treating COPD
smoking cessation
2 autonomic drugs used in treatment of COPD
beta 2 agonists, anticholinergics
____ corticosteroids are used in short term inhalers. ____ corticosteroids are used during periods of COPD exacerbation.
inhaled;
systemic
_____ inhibitors are specifically used in bronchitis patients
phosphodiesterase-4
what treatment is recommended at all stages of COPD?
exercise rehab
exercise rehab helps with improvements in _____ tolerance and symptoms of ____ and ____
exercise; dyspnea, fatigue
e.g. breaks the “spiral of disability/deconditioning”
what COPD treatment has been shown to increase survival in patients with severe, resting hypoxemia?
oxygen therapy (at least 15 hours a day)
non-invasive ventilatory support should be used in patients with pronounced day-time _____
hypercapnia (ie increased CO2)
Lung volume reduction surgery (LVRS) is more efficacious in patients with ____-lobe _____ and low _____ capacity
upper, emphysema;
exercise
what is indicated in patients with a PaO2 less than 55 and a SaO2 less than 88%?
long term oxygen therapy
what is “P” pulmonale?
tall peaked P waves;
indicates R. atrial enlargement
most common cause of exacerbation of COPD?
infection.
also edema, PE, pneumothorax, non-compliance
in patients with COPD exacerbation, ____, ____, or bleeding may be present on whole blood count
anemia, polycythemia (due to decreased O2)
