Obstructive Lung Disoders

Question 1

What two disorders cause COPD?

Answer 1

chronic bronchitis and emphysema

Question 2

True/False, digital clubbing is a common physical sign of COPD?

Answer 2

False. If you see it, be concerned about underlying lung cancer or chronic infection (like CF, bronchiestasis, abscesses, interstitial lung disease, etc)

Question 3

Both chronic bronchitis and emphysema cause airway obstruction but in 2 different ways, what are they?

Answer 3

Bronchitis is due to structural changes and mucus gland hypertrophy. Emphysema is a loss of alveoli and have decreased diffusion due to the loss of those capillaries.

Question 4

What are common presenting complaints of COPD in general?

Answer 4

SOB especially when lift arms (like brushing teeth or hair), chronic productive cough, pursed lip breathing

Question 5

How do we measure diffusing capacity?

Answer 5

patient inhales a mixture of helium and carbon monoxide, and measure what they exhale and can determine what their lung volume is how much CO they blew off. more CO lost = higher diffusing capacity.

Question 6

How do COPD patients respond to therapy?

Answer 6

poorly

Question 7

How can a PFT differentiate if the COPD is caused by chronic bronchitis or emphysema?

Answer 7

Diffusing capacity is normal in chronic bronchitis and decreased in emphysema (think of those alveoli!)

Question 8

Hyperresonance over the lungs on percussion can be indicative of what?

Answer 8

Over-inflation, like due to emphysema or pneumothorax

Question 9

If a patient has SOB due to difficulty exhaling all of their air, is this characteristic of a restrictive or an obstructive disorder?

Answer 9

Obstructive due to increased resistance. Restrictive has a hard time inhaling due to loss of compliance.

Question 10

A patient with a history of smoking is more like to develop an obstructive or restrictive lung disorder?

Answer 10

Obstructive, which have pulmonary origins. Restrictive disorders have more of an extra pulmonary (like musculoskeletal) origin.

Question 11

Chronic bronchitis diagnosis is defined by excessive secretion of bronchial mucus with daily productive cough for how much time?

Answer 11

For 3 months or more in at least 2 consecutive years

Question 12

True/False. There is obvious fibrosis on the CXR of a patient with emphysema.

Answer 12

False.

Question 13

What ages are patients who typically get diagnosed with emphysema? Chronic bronchitis?

Answer 13

Emphysema usually present after age 50. Bronchitis often presents in late 30s-40s

Question 14

describe the body habitus of a typical patient with emphysema? bronchitis?

Answer 14

E: patients are thin, with recent weight loss.
B: patients overweight and cyanotic

Question 15

Which vaccinations are indicated in patients at risk or with COPD?

Answer 15

Seasonal flu shot and pneumococcal vaccine