PT7: COPD

Question 1

what is COPD

Answer 1

airflow obstruction that is irreversible

Question 2

what is the main cause of COPD

Answer 2

smoking

Question 3

what is FEV1

Answer 3

forced expiratory volume; maximum amount of air expired in one second

Question 4

what is FVC

Answer 4

vital capacity, the amount of gas remaining at the end of normal respiration

Question 5

what is FEV1/FVC

Answer 5

ratio of forced expiratory volume in one second to forced vital capacity
this is reduced in COPD

Question 6

what is chronic bronchitis

Answer 6

daily productive cough that lasts for three months of the year and at east two years in a row

Question 7

what is emhysema

Answer 7

damage to the air sacs in the lungs

Question 8

what are the clinical features of COPD

Answer 8

exertional dyspnoea, cough, sputum production, wheeze, symptoms are fixed while disease course is progressive

Question 9

what assessment tools are used for COPD

Answer 9

COPD assessment test
chronic respiratory questionnaire
st george's respiratory questionnaire
chronic respiratory questionnaire
modified medical research council questionnaire

Question 10

what type of inhalers are used in triple therapy

Answer 10

LAMA, LABA, ICS

Question 11

when would you consider triple therapy

Answer 11

pts taking LABA/LAMA who have a severe exacerbation, two moderate exacerbations within a year, three month trial if symptoms affect daily life

Question 12

what drugs are used in a trimbow inhaler

Answer 12

beclometasone, formoterol, glycopyrrolate

Question 13

when is step-down from triple therapy considered

Answer 13

pts treated with ICS/LABA/LAMA but have never suffered exacerbations

Question 14

what are some examples of oral treatments used in COPD

Answer 14

corticosteroids, mucolytics, theophylline, prophylactic antibiotics, rolflumilast

Question 15

what is roflumilast

Answer 15

long-acting selective phosphodiesterase-4 enzyme inhibitor that targets cells and mediators believed to be important in COPD

Question 16

what are some examples of acute exacerbations

Answer 16

increased SOB, worsening cough, increased sputum production, change in sputum colour

Question 17

how can exacerbations be prevented

Answer 17

flu vaccines, optimise inhaler therapy, education, emergency abx/steroids at home

Question 18

how can medical management be optimised

Answer 18

controlled oxygen, bronchodilators, systemic steroids, antibiotics, mucolytic, thromboprophylaxis

Question 19

what is a venturi mask

Answer 19

delivers O2 from 24% to 60% with flow rates from 4 to 12L/min
minimal CO2 build up

Question 20

when does respiratory failure occur

Answer 20

when disease of the heart or lung leads to failure to maintain adequate blood oxygen levels or increased blood CO2 levels

Question 21

what is respiratory failure defined by

Answer 21

arterial partial pressure less than 8kPa of O2 or arterial pressure of CO2 greater than 6.7kPa