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PHTH 536 - Body Systems > Pulmonary - COPD > Flashcards

Pulmonary - COPD Flashcards

1
Q

What is COPD?

What is the mechanism? - A picture

A

deterioration of small airways because of the chronic inflammation

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2
Q

How is the gas exchange of COPD?

A

mismatched perfusion @ capillary membrane = hypoxemia

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3
Q

How does hypoxemia progress to?

A

hypercapnia (increased CO2 in the arterial blood) = pulmonary hypertension

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4
Q

The progression of COPD contributes to what?

A

Decreased O2 in arterial blood

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5
Q

What are the possible causes of COPD?

A
  • loss of elastic recoil = collapsed airway (air trap)
  • walls between alveoli are destroyed and dilation of alveolar spaces
  • increased compliance of lung tissue
  • more mucus = clogged airways
  • normal exhalation = thorax returned to resting position
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6
Q

What does the closed airway contribute to?

A

cyclic hyperinflation = thorax can’t go back to resting position

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7
Q

What is the prevalence of COPD?

A
  • 3rd leading cause of death
  • 4th leading cause of death in the U.S in general
  • 1 in 5 have COPD
  • 16 milly+
  • gets lots of ER visits
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8
Q

What is the general demographics of COPD?

A
  • over 40 with increased age around 65-75
  • women more than men
  • smoking (duh)
  • lower income
  • unemployed, retired and disable
  • increased risk in SE and MW regions
  • rural areas more likely
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9
Q

What is the most common cause of COPD regarding demographics?

A

Smoking (80%)
never smoked (10-25%)
Poor air quality

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10
Q

What are the risk factors of COPD?

A

occupational exposure
exposure to air pollution
age
cigarette smoking
childhood respiratory conditions
genetics

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11
Q

What are the important components for the patient hx?

A
  1. former/current smoker
  2. exposure to passive smoking
  3. environmental exposures
  4. occupational dusts and chemicals
  5. hx of childhood respiratory conditions
  6. older age
  7. family hx
  8. SOB with activity
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12
Q

What is the common clinical presentation?

A
  • most common sx = dyspnea
  • chronic cough
  • barrel chest
  • wheezing
  • reduced or absent breath sounds
  • retain CO2

For dyspnea - usually with exertional activities / worsens over time and becomes apparent with lower-level ADL

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13
Q

COPD testing

What does spirometry measure for pulmonary function testing?

A

time-volume relationships in the lungs

The gold standard

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14
Q

COPD testing

Obstructive disease is characterized by?

A

Delay and incomplete emptying of the lung during exhalation which would benefit from testing to diagnose

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15
Q

COPD PFT

What is the process of PFT-spirometry?

A

Two forced expiratory volumes monitored are forced expiratory volume in 1-sec and forced vital capacity

FEV1/FVC ratio = >75% is normal

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16
Q

COPD PFT

What is used for?

A

Used to quantify degrees of airway obstruction, document baseline and follow progression of disease

demonstrate altered volumes and capacity over time = air trapping

17
Q

What is the classifications of COPD severity?

A

mild = add short-acting bronchodilator
mod = add long-acting brochodilator + rehab
severe = add inhaled corticosteroids
very severe = add O2 if respiratory failure (possible surgical options)

18
Q

What is the grades of breathlessness?

19
Q

What is BODE index? What is it’s purpose?

A

A multidimensional index for severity of COPD
= good predictor of survival and hospitalization
= BODE is btter predictor than FEV1 alone

20
Q

BODE Index

0 to 2 points indicates?

A

80% survival

21
Q

BODE Index

3 to 4 points indicates?

A

67% survival

22
Q

BODE Index

5 to 6 points indicate?

A

57% survival

23
Q

BODE Index

7 to 10 points indicate?

A

18% survival

24
Q

What is the medical management for COPD?

A
  • stop smoking LOL
  • pharmacotherapy
  • influenze vaccine
  • pneumonia vaccine
  • treatment of sleep disorders
  • pulmonary rehab - exercise training
  • surgery
25
Q

What are the drugs used for COPD?

A

Mucolytics
bronchodialtors
steroids

26
Q

What is emphysema?

A

condition of the lung where the alveolar walls are destroyed and enlargement of airspaces distal to terminal bronchioles

27
Q

What is the clinical presentation of chronic bronchitis?

A
  • having a cough for 3 months in each of 2 successive years
  • the use of accessory muscles
  • elevated shoulder
  • barrel chest
  • fatigue
  • anxiety
28
Q

Chronic bronchitis

Where does hypersecretion start?

A

starts at large airways and goes to smaller airways = hypertrophy of submucosal glands

29
Q

Appearance of emphysema vs chronic bronchitis

ISSA PICTURE

30
Q

What is the clinical presentation of chronic bronchitis?

A

thorax ROM - decreased excursion
- muscle of ventilation is stretched
- diaphragm can’t return to dome shape on exhalation = flattens over time

PHTH 536 - Body Systems (28 decks)

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