Quiz 6: COPD, Asthma, Bronchiectasis, Cystic Fibrosis Flashcards
What is COPD? Is it treatable?
Excessive airway inflammatory processes eventually lead to abnormalities in lung structure that permanently obstruct airflow. Usually progressive.
Reduced expiratory flow and slow forced emptying of the lungs.
Only minimally reversible with bronchodilators.
How many people are affected by COPD in the US?
Over 1/5 of adults
3rd leading cause of death
What is the primary cause/risk factor for COPD? What are other causes/risk factors?
Smoking (primary risk factor - 90% of deaths)
Air or Industrial pollution, 2nd hand smoke, childhood respiratory infections, Viral infections (adenovirus, RSV), alpha-1-antitrypsin (AAT) deficiency (familial emphysema), asthma
What are the general symptoms of COPD?
Dyspnea (worsens with exertion), chronic productive cough, wheezing, barrel chest, use of accessory muscles, hyperresonance, cyanosis
What might you do as part of your diagnostic work up for a patient with COPD?
Pulm Function Tests (inc TLC), Pulse ox, CBC, Arterial blood gases (ABGs), Alpha-1-Antitrypsin level (FHx), CXR, Chest CT, in-office Forced Expiratory Time (FET) test
What are two forms of COPD?
Emphysema and Chronic bronchitis
What is emphysema?
Permanent enlargement of alveolar ducts and air spaces distal to terminal bronchioles with destructive changes in alveolar walls, a loss of elastic recoil, fibrosis, scarring. Gradual progression with years of cigarette smoking typically preceding. Predominantly >50 yo
How many cases of emphysema are due to Alpha 1-antitrypsin (AAT) deficiency? What happens in this disorder?
1-3% of cases
AAT, produced by the liver, is a “lung protector.” In the absence of AAT, pt has SOB and reduced exercise capacity, emphysema is almost inevitable.
What are the Sn/Sx you might see in a COPD patient?
“pink puffers”– work very hard to breathe
dyspnea from mild exertional distress to cyanosis at rest
exercise intolerance
cough is rare; scant clear mucus
