Pulmonary Clinical Medicine I: Asthma and COPD Flashcards
What sex is asthma more common in childhood?
What sex is it more common in puberty/young adulthood?
1) Boys
2) Women
What are prenatal risk factors for asthma?
Which is deemed the highest risk?
1) Ethnicity
2) Low SES
3) C-section
4) Maternal tobacco smoking
5) Prematurity (*Highest risk factor)
What are postnatal risk factors for asthma?
1) Levels of endotoxins and allergens within the home (esp. dust mites)
2) Viral and bacterial infection (RSV and adenovirus)
3) Air pollution
4) Antibiotic use
5) Acetaminophen exposure
6) Obesity
What does the T2-type airway inflammation of asthma cause?
Airway remodeling
What composes airway remodeling?
1) Increased airway smooth muscle
2) Thickened subepithelial reticular lamina
3) Increased mucous cells in new areas
4) Increased mucus production
What is found on spirometry that makes an asthma diagnosis more likely?
1) FEV1 of <80%
2) Age adjusted FEV1/FVC of <75%
What is the hallmark of asthma that separates it from COPD?
Reversibility of airway obstruction
What classifies a patient as mild, persistent asthma in terms of days/week of symptoms experienced?
Amount of night time awakenings for 0-4 year olds in a month?
Amount of night time awakenings for 5 and up in a month?
Amount of asthma exacerbations that require oral systemic corticosteroids in a year?
1) More than twice a week
2) 1-2 a month
3) 3-4 a month
4) 2 or more a year
What classifies a patient as moderate, persistent asthma in terms of the amount of times they need to use a short acting beta agonist to control symptoms?
What classifies a patient as severe, persistent asthma in these terms?
1) Daily
2) Several times a day
What is the major goal of an individualized written asthma action plan?
Provide best quality of life by minimizing symptoms and stopping exacerbations
What is the most common complication of asthma?
How is this managed?
1) Asthma exacerbation
2) Prevention of triggers
What is the best studies asthma prevention measure?
Breastfeeding
What is the hallmark of COPD that separates it from Asthma?
Airflow limitation in COPD is largely irreversible
COPD mortality rates are higher in what sex?
The rates rise exponentially with?
The strongest association with mortality from COPD is with?
1) Men
2) Age
3) Poverty
What is the most common cause of COPD?
What is the next common cause?
1) Smoking
2) TB
What genetic factor combined with smoking causes approximately a threefold increased risk of developing COPD?
A patient that smokes with first-degree relatives with COPD
What are the main pathological features of COPD?
1) Obstructive bronchiolitis
2) Emphysema
3) Mucus hypersecretion
How does COPD clinically present?
1) Decreased capacity to exercise
2) Low muscle strength
3) Low BMI
How is COPD diagnosed on spirometry?
1) FEV1/FVC <0.7
2) Low FEV1
3) <12% reversibility
What is the mainstay treatment for COPD in order to improve lung function and reduce breathlessness?
What is used to Tx COPD for those at high risk of exacerbation?
When and why is oxygen used to Tx COPD?
1) Bronchodilators
2) Inhaled corticosteroids
3) If SaO2 < 88% because it reduces mortality
What is given for COPD acute exacerbations if there is increased sputum purulence or volume?
Oral antibiotics
What vaccinations are recommended for prevention of COPD exacerbations?
Influenza and Pneumococcal
