Flashcards
COPD
Cards in this deck (23)
- 1Diagnosis of chronic bronchitisChronic cough productive of sputum
At least 3 months/yr for 2 consecutive yrs - 2Pathogenesis of obstruction secondary to chronic bronchitis- Excess mucus production narrows airways
- Inflammation and scarring in airways, enlargement of mucous glands, and smooth muscle hyperplasia --> obstruction - 3How are alveolar walls destroyed in emphysema?Relative excess in protease (elastase) activity
OR
Deficiency of antiprotease (α1-antitrypsin) activity - 4Elastase & α1-antitrypsinElastase is released from PMNs and macrophages and digests human lung
α1-antitrypsin inhibits elastase - 5Most common early symptom of COPDExertional dyspnea
- 6What type of emphysema is typically associated with smoking?Centrilobular
Destruction limited to proximal acini with little change in distal - 7What type of emphysema is associated with α1-antitrypsin deficiencyPanlobular
Destruction involves both proximal and distal acini - 8FEV1/FVC ratio in COPD<0.7
- 9Increased or decreased in COPD? 1. FEV1 2. TLC 3. RV1. FEV1 decreased
2. TLC increased
3. RV increased - 10To diagnose airway obstruction, patient must have a _______ or ________ TLC with a _________ FEV1.Normal or increased TLD with
decreased FEV1 - 11"Pink puffers" vs. "Blue bloaters" Which is which?Pink puffers - emphysema
Blue bloaters - chronic bronchitis - 12Expiratory time is _________ in COPD.prolonged
- 13GOLD staging of COPDMild - FEV1 ≤ 80% predicted
Moderate - FEV1 50-80% predicted
Severe - FEV1 30-50% predicted
Very severe - FEV1 <30% - 14Vital capacity is _____ in obstructive lung disease and ______ in restrictive.low and low
- 15COPD leads to chronic respiratory _________ with metabolic ________ as a compensation.Respiratory acidosis
Metabolic alkalosis - 16At around age ____, FEV1 decreases ___ to ____ mL/yr, in a non-smoker.Age 35
25-30 mL/yr - 17How does rate of decline of FEV1 change for a smoker when he/she quits smoking?Slows to that of a nonsmoker of the same age
- 18Respiratory symptoms should improve within ______ of quitting smoking1 year
- 19Criteria for long-term oxygen therapy in COPDPaO2 55mmHg
OR
O2 sat ≤88% either at rest or during exercise
OR
PaO2 55 to 59mmHg plus polycythemia or evidence of cor pulmonale - 20_________ has more side effects than other bronchodilators and a narrow therapeutic index, but it is occasionally used for refractory COPDTheophylline
- 21O2 saturation goal during acute COPD exacerbation90-93%
- 223 complications of COPD- Acute exacerbations
- Secondary polycythemia (HCT >55% in men or >47% in women)
- Pulmonary HTN and cor pulmonale - 23T/F: Systemic corticosteroids should be used long-term only for patients with severe COPD.False; systemic corticosteroids should NOT be used long-term for COPD patients, event if disease is severe. Their only role is in acute exacerbations.
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- USMLE Step 2 Pulmonology (2a Obstructive Lung Disease) Flashcards on COPD, created by Aaron Samide on 18/05/2016.
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- Aaron Samide
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