Module 2 COPD Flashcards
(196 cards)
LAMA
Long acting controller for smooth muscle relaxation and dilation.
- Slower onset w/long duration
- Long acting muscarinic antagonists
Is tiotropium a LAMA or SAMA?
LAMA
COPD is largely caused by smoking; according to GOLD what is the more definitive cause?
Complex mix of genes and environment
COPD symptoms
SOB
Chronic cough
Sputum
Risk factors for COPD
Host Factors, but generally:
- Tobacco
- Occupation
- In/outdoor pollution
- Genetic predisposition
- COPD increases with age
How do you test/diagnosis COPD?
Spirometers
(FEV1/FVC)
COPD is formally diagnosed via spirometers to test post-bronchodilator. FEV1/ FVC ratio.
what ratio would be consistent with COPD?
FEV1/ FVC ratio less than 0.70
Add slides on patient history
edit
How is Spirometry used as a tool to diagnose COPD?
aka how does it work?
Objectively measures airflow limits
What does normal vs obstructed airflow look like?
Is COPD a obstructive or restrictive disease?
obstructive
What is the difference between obstructive and restrictive lung diseases?
obstructive: make it hard to exhale air out of the lungs.
Restrictive: makes it hard to expand their lungs with air.
What are 2 pathologies that make up COPD
Chronic bronchitis and emphysema
What is dynamic compression?
When (+) intrathoracic pressure during forced expiration exceeds the pressure inside the airways causing them to collapse
- Premature compression of airways; leading to increased airway resistance
What are causes of increased airway resistance in a COPD patient
Air trapping
Increased secretions
What direction does the equal pressure point (EPP) move in COPD?
Toward the alveoli into the non-cartilaginous airways
- Alveoli and smaller bronchioles lack cartilage = more prone to dynamic compression
- Palv < Ppl = airway collapse
- Palv > Ppl normally (drives exhalation)
Common symptoms of COPD
Persistent cough
Increased mucous production
Dyspnea
Muscle fatigue
Hallmark sign of COPD
productive cough
Panlobular emphysema
Type of emphysema involving distention and uniform destruction of the entire primary respiratory lobule (acinus)
- Associated with 1-antitrypsin deficiency
- Lower lobes predominantly
Centrilobular emphysema
Weakening and enlargement of respiratory bronchioles in the proximal portion of acinus.
- Associated with smoking, aging, and/or air pollution
- Chronic bronchitis is also associated with this
What criteria would classify as Chronic bronchitis?
presence of cough and sputum production for at least 3 months in 2 consecutive years
What does emphysema cause?
Airway remodeling + loss of elastic recoil -> permanent enlargement of alveolar walls + cap beds
- Oxidative stress
- enzyme; enzyme inhibitor imbalance.
Symptoms to consider a diagnosis for COPD?
- dyspnea
- recurrent lower resp. tract infection
- chronic cough/sputum
- history of risk factors
GOLD diagnosis of COPD
FEV1/ FVC ratio < 0.70