Medicine: COPD Reduced

Helpfulness: 0
Set Details Share
created 8 years ago by jgaversa5
50 views
updated 8 years ago by jgaversa5
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:
1

what are the variables of consideration in COPD

Cough/Wheeze/Dyspnea
Airflow Obstruction
Hyperinflation
Diffusion

2

what is CWD like in asthma

acute CWD

3

what is aiflow obstruction like in asthma

reversible

4

what is hyperinflation like in asthma

transient

5

what is diffusion like in asthma

normal

6

what is WDC like in CB

chronic W/C
varialble D

7

what is airflow obstruction like in CB

reversible to irreversible

8

what is hyperinflation like in CB

mild to moderate

9

what is diffusion like in CB

normal to decreased

10

what is WCD like in emphysema

dyspnea
variable cough/wheeze

11

what is aifrlow obstruction like in emphysema

irreversible

12

what is hyperinflation like in emphyseam

moderate to severe

13

what is diffusion like in emphysema

reduced

14

when having COPD what do you have risk factors for

Atherosclerotic heart disease
lung cancer
osteoporosis
depression

15

what are the main COPD risk factors

smoking
environment
genetics
demographics

16

what are the main risk factors for nonsmokers for COPD

age
heart disease
CVA (stroke)
being female

17

what is the progression from terminal bronchiole to alveoli

terminal bronchial to respiratory bronchiole to alveolar duct to alveolar sac to alveoli

18

define emphysema

permanent, abnormal enlargement of any part of the gas exchange structure with tissue destruction

19

what are the types of emphysema

centriacinar
panacinar
distal acinar (paraseptal)

20

what is a bullae

airspace over 1 cm

21

what causes panacinar emphysema (disruption of what)

protease/antiprotease imbalance

22

what provides protease in the lungs

alveolar MPs and PMNs

23

what is the antiprotease in the lungs

A1AT

24

define chronic bronchitis

3 months or more for 2 consecutive years of chronic excess mucus

25

what is chronic bronchitis primarily a disorder of (structure)

bronchial wall abnormality

26

what is inovlved in the bronchial wall abnormality of chronic bronchitis

mucus hypertrophy and chronic inflammatory cell infiltrate

27

what is an important metric considered with chronic bronchitis

Reid index

28

what is the reid index

gland to wall thickness

29

what is a normal person's Reid indiex

0.33

30

what is a CB person's Reid index

0.5

31

what are the two basic determinants of aiflow

flow=force/resistance

32

what COPD affects force and how

emphysema decrases force

33

what COPD affects resistance and how

asthma, emphsema, CB all increase resistance

34

what are some mixed bag things that can limit airflow

loss of alveolar attachements
airway obstruction due to inflammation
airway wall fibrosis
airway smooth muscle constriction
lumenal obstrusction with mucus

35

how will FRC and RV changes differ in emp and CB

very high in emp, moderately high in CB

36

how will TLC changes differ in emp and CB

high emp, mild increase in CB

37

how will DL changes differ in emp and CB

low in emp, normal to increase in CB

38

how will recoil changes differ in emp and CB

low in emp, normal to increase in CB

39

how will compliance changes differ in emp and CB

high in emp, decrease in CB

40

what are the clinical features of COPD (list)

DOE

usually productive cough

wheezing (variable)

cyanosis

cor pulmonale

erythrocytosis

spont PTX

41

what are the limitations to exercise in COPD due to

decreased maximal ventilation

increased dead spance

V/Q imbalance

deconditionng

42

what are the important factors in decreased ventilation that need consideration

MVV and MSV

43

what is a quick way to calculate MVV from PFTs

35*FEV1

44

what is the quick way to calculate MSV from PFTs

0.6*35*FEV1

45

what would happen to Vd/Vt in rest to exertion

0.3 to 0.1

46

what would happen to Vd/Vt in COPD at rest

0.5 (high)

47

what happens to PO2, DO2, and conditioning in V/Q imbalance

decreased all

48

what is the key for IBW in terms of COPD survival

over 90% so you use less energy for respiration

49

what are the cirect contributors to dyspnea

respiratory effrot

cortical effects

length tension relationships

50

what are the main COPD findings in physical exam

decrease breath sounds
wheezing
Hoover's sign
accessory muscles working hard with active respiration
cor pulmonale

51

what is hoover's sign

inspiratory retraction of lower intercostal spaces that occurs with obstrcutive airway disase

52

what is the stage I of COPD

unaware

53

what is FEV1/FVC throughout COPD

under 0.7

54

what is FEV1 in stage I

over 0.8

55

what is FEV1 in stage 2

0.5-0.8

56

what is stage 2 moderate CopD's main symptom

SOBOE

57

what is stage 3 (severe) COPD main symptoms

worse SOB like at rest

58

what is stage 3 COPD FEV1

0.3-0.5

59

what is very severe stage 4 COPD's main symptom

QOL severely impaired

60

what is severe stage 4 COPD FEV1

under 0.3

61

what are the treatment goals of COPD

ID early

prevent further destruction

maximize and optimize Pulmonary function

Correct damage

62

how do you prevent further lung destruction in COPD for most people

stop smoking, prophylactially treat, and change environment

63

how would you prevent further lung destruction in COPD for people who have pan-acinar emphysema

give A1AT replacement

64

how would you maximize pulmondary function for most people

drugs

65

what are the bronchodilators given in COPD

anticholinergics and B2's

66

what are the anti-inflammatories given in COPD

steroids

67

what are the things used to reverse muscle failre in COPD

VPAP and methylxanthines

68

what are given to minimize airway secreation in COPD

mucolytics

69

what is the first line of COPD meds

SABD and flu vaccine

70

what do you add for second line COPD meds

LABD and rehab

71

what do you add for third line COPD meds

glucocorticosteroids

72

what do you add for fourth line COPD meds

O2

73

what is uplift

tiotropium

74

does uplift help FEV1

no

75

what does uplift help

quality of life
less hospitalizeion and respiratory failure
decrease mortality

76

what are things focused on optimizing pulmonary funciton

rehab and nutrition

77

what do you focus on in terms of corrective measures for COPD

hypoxemia
PHTN
cor pulmoale
hypercapnea

78

what is the main treatment for hypercapnea

rest therapy

79

what is survival for lung transplant

under 2-3 years

80

what is FEV1 for lung transplant

under 25%

81

is there age criteria for COPD transplant

yes

82

are the lungs in COPD transplant usually free of exacerbations

no

83

what is tough about transplants overall

no organs
low survival
long waiting list

84

what is the specturm of A1AT deficiency from PiMM to Pnullnull

PiMM to PiMS to PiMZ to PiSZ to PiZZ to Pinullnull

85

will Pinullnull have engorged hepatocytes

no, no liver disease

but severe emphysema

86

will Pizz have cirrohsis

yes

87

what is the issue in CF moleuclarly

inhibition of Cl and Na absorption in duct

88

what will CF mostly show you

mucus production
bronchial wall edema/inflammation
bronchospasm

89

what are the classic infections of someone with CF

s. aureus
pseudomonas,
non-tuberculosis mycobacterium