SOB- COPD/Asthma

Question 1

Define COPD

Answer 1

abnormal inflammatory response to noxious gases/particles

Question 2

What are the four diagnostic criteria for COPD ?

Answer 2

1 chronic cough
2 chronic sputum production
3 dyspnea (progressive and persistent)
4 hx of exposure: smoking, occupational, …

Question 3

How can you differentiate between asthma and COPD?

Answer 3

1 COPD is usually a mid-life dx (progressive), while asthma tends to be younger patients

2. COPD is irreversible while asthma is at least partly irreversible with bronchodilators

Question 4

What are chronic symptoms of advanced COPD?

Answer 4

increased sputum production, wt. loss, hypercapnia leading to hypoxemia, cor pulmonale, morning HA

Question 5

What is the definitive test for a COPD diagnosis?

Answer 5

spirometry/PFT : FEV1/FVC <70%

Question 6

What are some physical signs of COPD?

Answer 6

prolonged expiration, increased AP diameter (“barrel chest”), hyper-resonance, flattened diaphragm, decreased breath sounds, wheeze

Question 7

How do you treat COPD?

Answer 7

1 smoking cessation (most important)
2 beta 2 agonist PRN
3 anticholinergic PRN -Ipratropium 
4 theophylline (?)
5 inhaled corticosteroids
6 short term oral corticosteroids

Question 8

When should you use supplemental O2?

Answer 8

O2 sats below 88% at rest or below 85% w/ exertion

or if they have cor pulmonale

Question 9

Name the three subtypes of COPD?

Answer 9

1 asthma
2 bronchitis
3 emphysema