Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHAM01 > Wk 14: COPD > Flashcards

Wk 14: COPD Flashcards

1
Q

What are the signs + symptoms of COPD?

A
  • Exertional breathlessness
  • Chronic cough
  • Regular sputum prod
  • Frequent winter bronchitis
  • Wheeze
  • Chest tightness
  • Fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the complications of COPD?

A
  • HF
  • Respiratory failure
  • Sleep apnoea
  • Repeated respiratory infections
  • Osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When would you consider a diagnosis of COPD?

A
  • > 35
  • Smoker/ex-smoker
    • symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What would you use to confirm a diagnosis of COPD?

A

Post-bronchodilator spirometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When would you consider/not consider a diagnosis of COPD using the spirometry?

A
  • Alt diagnose: older people w/ FEV1/FVC ratio below 0.7 + no typical symptoms
  • Diagnose: younger people w/ symptoms but FEV1/FVC ratio above 0.7
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What indicates a restrictive effect (lung fibrosis) using the spirometry?

A
  • FVC red + FEV1/FVC ratio >80%
  • Lung vol red
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What indicates an obstructive effect (asthma/COPD) using the spirometry?

A
  • FEV1 red more than FVC + FEV1/FVC ratio <80%
  • FEV1 < 80% predicted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Other than spirometry, what other measures are taken when diagnosing a patient?

A
  • Chest radiograph (exclude pathologies)
  • FBC (anaemia/polycythaemia)
  • BMI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the dyspnoea scale?

A
  1. Not troubled by breathlessness except strenuous exercise
  2. SOB hurrying/walking slight hill
  3. Walks slower on level ground bc breathless/stops for breath walking own pace
  4. Stops for breath after 100m or few mins on level ground
  5. Too breathless to leave house/dress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the GOLD classification of COPD?

A
  • Gold 1 (mild): FEV1 >80% predicted
  • Gold 2 (moderate): 50% < FEV1 <80% predicted
  • Gold 3 (severe): 30% < FEVs < 50% predicted
  • Gold 4 (v severe): FEV1 <30% predicted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When managing a patient, what lifestyle advise would you give a patient?

A

Self management plan:
- Stop smoking

  • Comply w/ meds
  • Regular exercise/pulmonary rehab
  • Regular flu vaccine + pneumococcal vaccine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What would you offer for smoking cessation?

A
  • NRT
  • Bupropion
  • Varenicline: for smokers w/ desire to quit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When would you offer long term oral corticosteroids?

A

Advanced COPD that cannot be w/drawn following exacerbation - low dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would you monitor/offer alongside oral corticosteroids?

A
  • Osteoporosis
  • Start prophylaxis w/o monitoring if >65
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When would you offer theophylline?

A
  • Trial of short acting bronchodilators + long acting bronchodilators
  • Unable to use inhaled therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When would you be cautious when giving theophylline?

A
  • Older: inc interactions
  • Macrolide/fluoroquinolone antibiotics: red dose
17
Q

When would you consider offering a mucolytic drug?

A
  • Chronic cough productive sputum
  • Continue if improvement
  • Don’t routinely use if stable
18
Q

What prophylactic antibiotic is given to people with COPD?

A

Azithromycin 250mg 3 times a week

19
Q

Who would you only give prophylactic azithromycin to?

A
  • Don’t smoke AND
  • Optimised non-pharmacological management, inhaled therapies, vaccines + referred for pulmonary rehab AND
  • Frequent (4x year) exacerbations w/ sputum OR
  • Prolonged exacerbation w/ sputum
  • Exacerbation = hospital
20
Q

What is used to monitor patients progress + during exacerbations?

A
  • Oxygen sats (97-99%)
  • Refer if sp02 <92% on more than 1 occasion
21
Q

When would you be cautious when giving oxygen to COPD patient?

A

Red alveolar ventilation w/ low PaO2 + high PaCO2

  • Cyanosed but not breathless
  • Respiratory centres insensitive to CO2
  • Rely on hypoxic drive to maintain respiration
22
Q

What is the target oxygen saturation in a patient with COPD, chest wall deformities + morbidly obese?

A

88-92%

23
Q

Why is 88-92% the target?

A
  • Uncontrolled oxygen red depth + freq. breathing
  • Leads to rise in blood CO2 levels + fall in pH
  • Controlled oxygen: delivery service at flow rate that helps oxygen maintained btw 88-92%
24
Q

What are symptoms of exacerbations?

A
  • Worsening breathlessness/dyspnoea
  • Cough
  • Inc sputum
  • Change in sputum colour
25
Q

What is first line choice of oral antibiotics?

A
  • Amox: 500mg TDS 5 days
  • Doxy: 200mg 1st day then 100mg for 5 day course
  • Clarith: 500mg BD 5 days
26
Q

What is the self management treatment for exacerbation?

A
  • Oral corticosteroid if inc breathlessness
  • Antibiotic if sputum purulent
  • Adjust bronchodilator to control symptoms
27
Q

Who would you refer to if a patient is stable with COPD + has exercise limitations due to breathlessness?

A

Pulmonary rehabilitation programme:
- Multidisciplinary interventions

  • Physical training
  • Disease education
  • Nutritional, psychological + behavioural intervention

PHAM01 (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions