Obstructive Diseases

Question 1

COPD Pathophys

Answer 1

• Airflow limitation

Question 2

COPD Sx

Answer 2

• Progressive SOB, cough, sputum, hemoptysis, wheeze

Question 3

COPD Dx

Answer 3

• Good hx (work, env, smoking) and PE
• CXR
• SPO2
• CBC
• ECG
• Spirometry

Question 4

COPD Tx

Answer 4

• Goal is to prevent worsening and control sx
• STOP SMOKING
• Long term O2 therapy
• Bronchodilators
• Steroids

Question 5

COPD GOLD Criteria

Answer 5

Based on FEV1:

• Mild >80%
• Moderate 50-80%
• Severe 30-50%
• Very severe <30%

Question 6

Chronic Bronchitis Pathophys

Answer 6

• Chronic inflam of small airways

- Excess mucous production

Question 7

Chronic Bronchitis Sx

Answer 7

• Productive cough lasting >3 months in 2 successive yrs

Question 8

Emphysema Pathophys

Answer 8

• Abnormal and permanent enlargement of airspaces due to chronic inflam
• Problem w/ gas exchange

Question 9

Asthma Pathophys

Answer 9

• Chronic inflam of airways and cells
• Airway hyper-responsiveness
• Lots of mucous
• Bronchospasms

Question 10

Asthma Sx

Answer 10

• Episodic wheezing, SOB, chest tightness, cough

- Worse at night

Question 11

Asthma Dx

Answer 11

• Good H&P
• Attacks usually have trigger
• CBC, CXR, SPO2

Question 12

Asthma Tx

Answer 12

• Based on sx

- Bronchodilator

Question 13

Asthma “Levels”

Answer 13

• Mild intermittent
• Mild persistent
• Moderate persistent
• Severe persistent

Question 14

Acute Bronchitis Etiology

Answer 14

• Viral inf is most common cause

Question 15

Acute Bronchitis Pathophys

Answer 15

• Lower resp tract inflam

- Excess mucous (due to damaged cilia)

Question 16

Acute Bronchitis Sx

Answer 16

• Persistent productive cough (lasts weeks)

- Worse at night and w/ exercise

Question 17

Acute Bronchitis Dx

Answer 17

• Clinical dx

- Hx (recent URI?)

Question 18

Acute Bronchitis Tx

Answer 18

• None

- Just supportive (analgesics, antipyretics, antitussives, hydration, rest)

Question 19

Bronchiectasis RF

Answer 19

• Age

- Female

Question 20

Bronchiectasis Etiology

Answer 20

• Idiopathic

- Infection, impaired drainage, airway obstruction, defect in defense

Question 21

Bronchiectasis Pathophys

Answer 21

• Permanent dilation of bronchi due to destruction of elastic and muscular parts of bronchial wall

Question 22

Bronchiectasis Sx

Answer 22

• Chronic productive cough

Question 23

Bronchiectasis Dx

Answer 23

• Sputum culture
• Hx (childhood inf, immunodef)
• CXR
• SPO2
• CBC
• CT chest**

Question 24

Bronchiectasis Tx

Answer 24

• Long term abx
• Resp therapy
• Nebulized bronchodilator or hypertonic saline
• Surgery
• Lung transplant