Copd

Front 1

what do we use to measure pulmonary function

Back 1

vital capacity (breathe in as deeply and out as hard)

Front 2

which value would be abnormal in someone with obstructive lung disease FEV 1 or 6 and why

Back 2

1 would be abnormal. due to the obstruction they won't be able to move air as fast as someone w/o

FEV 6 will look normal

Front 3

an increased FEV1/FVC ratio means what

Back 3

restriction (pulmonary fibrosis, pulmonary edema)

Front 4

a decreased FEV1/FVC ratio means what

Back 4

obstruction (COPD, asthma)

Front 5

why should asthma pt use a peak flow monitor

Back 5

when an attack is impending their peak flow will drop before they become symtomatic so peak flow can be used to detect asthma attack

Front 6

how do you check to see if an obstruction is reversible

Back 6

do bronchodilation test and if obstruction is present give them a bronchodilator and if there's less obstruction then its reversible

Front 7

which one responds to bronchodilators asthma or COPD

Back 7

asthma

Front 8

what are risk factors for COPD

Back 8

asthma
alpha antitrypsin deficiency

Front 9

what is the only way to prevent COPD progression

Back 9

smoking cessation

Front 10

what are the subsets of COPD

Back 10

chronic bronchitis
emphysema

Front 11

what occurs in emphysema

Back 11

go from small sacks w/ large SA to large sacks w/ small SA

Front 12

which form of COPD has mucus/sputum

Back 12

chronic bronchitis

Front 13

which form of COPD do you get a cough after short of breath for a while

Back 13

emphysema

Front 14

which form of COPD is bronchial infections more frequent

Back 14

chronic bronchitis

Front 15

which form of COPD does Cor Pulmonale occur more in

Back 15

chronic bronchitis

Front 16

what is the diff between Chronic bronchitis and Emphysema when it comes to exacerbations

Back 16

usually when someone w/ COPD has an exacerbation it is usually terminal where as someone w/ Chronic Bronchitis will be in and out of the hospital for exacerbations

Front 17

which form of COPD has a higher [] of CO2 and why

Back 17

chronic bronchitis

Front 18

which form of COPD has a higher hematocrit and why

Back 18

chronic bronchitis because they tend to accumulate more CO2 and have less O2 so they are trying to utilize it to its maximum

Front 19

what is emphysema

Back 19

loss of surface area gas exchange

Front 20

what is chronic bronchitis

Back 20

excess mucus production

Front 21

an FEV1 around what is detrimental

Back 21

bellow 50%

Front 22

how does Chronic bronchitis and emphysema progess

Back 22

chronic bronchitis: more and more frequent exacerbations

emphysema: worse dyspnea leading to an exacerbation that can be terminal

Front 23

what are the drugs of choice for COPD

Back 23

anticholinergic
sympathomimetic
oxygen
corticosteroids
theophyline

Front 24

people w/ COPD respond best to what?

Back 24

anticholinergics

Front 25

how do anticholinergics work

Back 25

they prevent bronchoconstriction

Front 26

what are examples of anticholinergics

Back 26

ipatropium (atrovent)
tiotropium (spiriva)

Front 27

what is the long acting and short acting anticholinergics

Back 27

ipatropium (atrovent) short
tiotropium (spiriva) long

Front 28

how do sympathomimetics work

Back 28

bronchidilators

Front 29

why would you give a sympathomimetic to someone w/ COPD

Back 29

they may have some minimal reversibility but not enough to be classified as asthma so the sympathomimetic will releave symptoms

Front 30

what are the sympathomimetics

Back 30

albuterol (proventil)
sameterol (serevent)

Front 31

why would you use corticosteroids in acute exacerbations

Back 31

the inflammation is reversible in nature so short term therapy w/ corticosteroids is beneficial

Front 32

how do Methylxanthines work

Back 32

bronchodilators

may be metabolized by smoking

Front 33

how is oxygen used to manage COPD

Back 33

may increase life span in advanced disease of COPD

Front 34

what are some other agents used to manage COPD

Back 34

antileukotrienes
mucolytics
opiods

Front 35

why are opiods used to treat COPD since they generally decrease respiration

Back 35

increased CO2 in COPD pt contributes to dyspnea and opiods make you feel less worse when dyspnea occurs possibly by resetting the CO2 Rc to become less sensitive

typically given to people on end stages of COPD

Front 36

what is an acute exacerbation

Back 36

changes in a pts baseline dyspnea, cough, sputum

Front 37

what can be given to manage acute exacerbations

Back 37

bronchodilators
antibiotics
short course of steroids

Front 38

why would you give a bronchodilator to treat acute exacerbations

Back 38

the inflammation is more reversible in nature and will respond well to bronchodilators

Front 39

why and when do you give antibiotics to treat acute exacerbations

Back 39

give antibiotics if worsening in 2 clinical symtoms (sputum/cough/dyspnea)


used to treat pathogens: pneumococcus, h. influenza, m. catarrhalis

Front 40

what vaccinations would you give for COPd and why

Back 40

influenza (lethal/severe if they get it)
pneumococcal (some say worthless cause usually colonized by pneumococcal so should have max Ab already)

Front 41

what extrapulmonary complication can occur b/c COPD (which subset?)

Back 41

Cor Pulmonale (common in Chronic bronchitis)

increase CO2 in blood causes constriction on the pulmonary artery causing the right ventricle to work harder and it eventually wears out leading to pulmonary hypertension (right sided heart failure)