5470141
Description
Flashcards by Aaron Samide, updated more than 1 year ago
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Created by Aaron Samide
almost 8 years ago
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| Question | Answer |
| Diagnosis of chronic bronchitis | Chronic cough productive of sputum At least 3 months/yr for 2 consecutive yrs |
| Pathogenesis 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 |
| How are alveolar walls destroyed in emphysema? | Relative excess in protease (elastase) activity OR Deficiency of antiprotease (α1-antitrypsin) activity |
| Elastase & α1-antitrypsin | Elastase is released from PMNs and macrophages and digests human lung α1-antitrypsin inhibits elastase |
| Most common early symptom of COPD | Exertional dyspnea |
| What type of emphysema is typically associated with smoking? | Centrilobular Destruction limited to proximal acini with little change in distal |
| What type of emphysema is associated with α1-antitrypsin deficiency | Panlobular Destruction involves both proximal and distal acini |
| FEV1/FVC ratio in COPD | <0.7 |
| Increased or decreased in COPD? 1. FEV1 2. TLC 3. RV | 1. FEV1 decreased 2. TLC increased 3. RV increased |
| To diagnose airway obstruction, patient must have a _______ or ________ TLC with a _________ FEV1. | Normal or increased TLD with decreased FEV1 |
| "Pink puffers" vs. "Blue bloaters" Which is which? | Pink puffers - emphysema Blue bloaters - chronic bronchitis |
| Expiratory time is _________ in COPD. | prolonged |
| GOLD staging of COPD | Mild - FEV1 ≤ 80% predicted Moderate - FEV1 50-80% predicted Severe - FEV1 30-50% predicted Very severe - FEV1 <30% |
| Vital capacity is _____ in obstructive lung disease and ______ in restrictive. | low and low |
| COPD leads to chronic respiratory _________ with metabolic ________ as a compensation. | Respiratory acidosis Metabolic alkalosis |
| At around age ____, FEV1 decreases ___ to ____ mL/yr, in a non-smoker. | Age 35 25-30 mL/yr |
| How 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 |
| Respiratory symptoms should improve within ______ of quitting smoking | 1 year |
| Criteria for long-term oxygen therapy in COPD | PaO2 55mmHg OR O2 sat ≤88% either at rest or during exercise OR PaO2 55 to 59mmHg plus polycythemia or evidence of cor pulmonale |
| _________ has more side effects than other bronchodilators and a narrow therapeutic index, but it is occasionally used for refractory COPD | Theophylline |
| O2 saturation goal during acute COPD exacerbation | 90-93% |
| 3 complications of COPD | - Acute exacerbations - Secondary polycythemia (HCT >55% in men or >47% in women) - Pulmonary HTN and cor pulmonale |
| T/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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