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24 Cards in this Set
- Front
- Back
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22. Stage 1 COPD (out of Stages 0-5): Classification?
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a. Mild COPD
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23. Stage 1 COPD (out of Stages 0-5): Findings?
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a. FEV1:FVC <0.7
b. FEV1≥80% of predicted c. With or without symptoms |
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24. Stage 1 COPD (out of Stages 0-5): Treatment?
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a. Short acting bronchodilators (albuterol and ipratropium)
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25. Stage 2 COPD (out of Stages 0-5): Classification?
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a. Moderate COPD
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26. Stage 2 COPD (out of Stages 0-5): Findings?
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a. FEV1:FVC <0.7
b. FEV1 50-80% of predicted c. With or without symptoms |
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27. Stage 2 COPD (out of Stages 0-5): Treatment?
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a. Long-acting bronchodilators: Salmeterol and Ipratropium (inhaled anticholinergic)
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28. Stage 3 COPD (out of Stages 0-5): Classification?
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a. Severe COPD
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29. Stage 3 COPD (out of Stages 0-5): Findings?
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a. FEV1:FVC <0.7
b. FEV1 30-50% of predicted c. With or without symptoms |
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30. Stage 3 COPD (out of Stages 0-5): Treatment?
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a. Inhaled steroids
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31. Stage 4 COPD (out of Stages 0-5): Classification?
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a. Very severe COPD
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32. Stage 4 COPD (out of Stages 0-5): Findings?
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a. FEV1:FVC <0.7
i. FEV1 <30% of predicted ii. Or iii. FEV1 <50% with hypoxemia (PAO2 ≤55 or SaO2 ≤88% at rest) or PaO2 ≤60 +polycythemia, pulm HTN, or peripheral oedema). |
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33. Stage 4 COPD (out of Stages 0-5): Treatment?
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a. Consider oxygen therapy + inhaled steroids
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34. Note: although smoking cessation does not result in significant improvement in pulmonary function, smoking cessation does reduce the rate of further deterioration to that of a non-smoker.
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a. Cessation also reduces the risks of other comorbidities, including cardiovascular diseases and cancers
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35. We should all patients with COPD receive?
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a. Pneumococcal and annual influenza vaccination
b. Influenza vaccination reduces the frequency and complication of exacerbations c. Regular exercise and efforts to maintain normal body weight should be encouraged. |
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36. What is the use of inhaled steroids (fluticasone, triamcinolone, mometasone) in COPD?
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a. They do not affect the rate of decline of lung function in COPD but do reduce the frequency of exacerbations.
b. For this reason, inhaled steroids are recommended for stages 3 and 4 COPD with frequent exacerbation!!!! |
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37. Note: long-term treatment with oral steroids is not recommended, as there is no evidence of benefit, but there can be multiple complications (myopathy, osteoporosis, glucose intolerance, etc).
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37. Note: long-term treatment with oral steroids is not recommended, as there is no evidence of benefit, but there can be multiple complications (myopathy, osteoporosis, glucose intolerance, etc).
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38. What is the only therapy that has been shown to decrease mortality in COPD?
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a. Oxygen therapy
b. It must be worn for at least 15 hours per day!!!! |
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39. Goal for oxygen therapy during an acute COPD exacerbation?
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a. Keep SaO2 > 90% or PaO2 at about 60 mm Hg.
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40. What shortens the course of a COPD exacerbation and may reduce the risk of relapse?
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a. Systemic steroids
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41. How much oral steroids be given for COPD exacerbation
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a. 40 mg prednisone (or equivalent) for 10 to 14 days is recommended!!!
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42. When should COPD exacerbations be treated with abx?
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a. When there is an increased amount of sputum or with purulent sputum.
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43. Most commonly implicated organisms in COPD exacerbation (3)?
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1. Pneumococcus
2. Haemophilus influenza 3. Moraxella catarrhalis |
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44. Aetiology of severe COPD exacerbation?
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a. Gram-negative bacteria (Klebsiella, Pseudomonas) also play a role, so abx coverage needs to be broader.
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45. complete
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45. complete
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