Resp Medicine - COPD

Question 1

chronic bronchitis definition

Answer 1

-productive cough on most days for at least 3 months for at least two consecutive years

Question 2

emphysema definition

Answer 2

-abnormal and permanent enlargement of the airways distal to the terminal bronchiole

Question 3

pink puffer =

Answer 3

purse lipped breathing & thin (emphysema)

Question 4

blue bloater =

Answer 4

cyanotic and barrel chest (bronchitis)

Question 5

Diagnostic tests for COPD?

Answer 5

Spirometry

• FEV1/FEV < 70
• reduced FEV1
• no or partial reversibility

Question 6

imaging for COPD?

Answer 6

CXRAY - hyperinflation

CT Thorax - may see emphasematous bulla, bronchial wall thickening, air trapping, airway enlargment

Question 7

appearance of hyperinflated lungs on cXRAY?

Answer 7

> 6 anterior ribs visible at midclavicular line or flattened hemidiaphrams

Question 8

blood tests for COPD?

Answer 8

-FBC
-CRP
-IgE and RAST - rule out asthma
-A1AT if suspected
-immunoglobulins for immunodeficiency
-

Question 9

what micro test should you do for COPD?

Answer 9

sputum culture

Question 10

test to check for cor pulmonale wiht COPD?

Answer 10

echo, BNP, ECG

Question 11

what is the GOLD score used for?

Answer 11

symptom/exacerbation assessment used to guide management

Question 12

GOLD A treatment

Answer 12

SABA or SAMA

Question 13

GOLD B treatment

Answer 13

LABA or LAMA

Question 14

GOLD C treatment

Answer 14

LAMA

Question 15

GOLD D treatment

Answer 15

LAMA or
LAMA + LABA or
LABA + ICS

Question 16

what is the DECAF score for?

Answer 16

-score used to predict mortality in patients with COPD exacerbation in hopsital

Question 17

DECAF SCORE parameters

Answer 17

D - dysnpea
E- eosinophilia
C- consolidation on CXRAY
A - acidemia < 7.3
F - fibrillation

Question 18

how to interpret the DECAF score?

Answer 18

0-1 = low mortality
2-6 = high mortality

Question 19

what is the BODE score for?

Answer 19

-predicts 4 year survival in patients with COPD

Question 20

BODE score parameters

Answer 20

B- BMI
O- airflow obstruction (FEV1)
D- dyspnea
E- exercise capacity (6 min walk test)

Question 21

indications for long term oxygen therapy?

Answer 21

• if PaO2 < 7.3

- if PaO2 < 8 AND evidence of pulmonary HTN

Question 22

how many hours a day should LTOT be used for?

Answer 22

15 +

Question 23

what is ipatroprium?

Answer 23

Short acting antimuscarinic

Question 24

what is tiotropium?

Answer 24

Long acting antimuscarinic