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31 Cards in this Set

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Chronic Obstructive Pulmonary Disease (COPD) definition.

comopare to asthma
Non-reversible airflow limitation

asthma is reversible
Chronic Obstruction of small airways
Chronic Bronchitis
Destruction of lung parenchyma, loss of lung elasticity, and enlargement of air spaces
Emphysema
___% of smokers develop COPD
14
__% of nonsmokers develop COPD
3
enzyme defici associated with COPD
alpha-1 antitrypsin defici
TEST QUESTION

Chronic Bronchitis

Definition: Productive cough for _?_ months for 2 years
3
Chronic Bronchitis:
Commonly referred to as “Blue _____"
Bloater
Chronic Bronchitis:
Hypersecretion of ____
mucous
Treatment of Chronic bronchitis
MAINSTAY: QUIT SMOKING

Anticholinergic inhalers
1) Ipratropium (Atrovent)
QID Meter Dose Inhaler or nebulizer
2) Tiotropium (Spitiva)
Once daily inhaled powder/capsule
TEST QUESTION

Acute Bacterial Exacerbation of Chronic Bronchitis (ABECB)

Worsening of symptoms (what?)
Increased shortness of breath
Change in sputum character (thicker, color change – yellow/green)
Generally, no fever
TEST QUESTION

most common etiology of Acute Bacterial Exacerbation of Chronic Bronchitis (ABECB)
Haemophilus Influenzae (H. Flu)

Others:
Mycoplasma
M. Catarrhalis
Treatment of ABECB
Start/continue Anticholinergic
Short acting Beta 2 Agonist
Systemic Corticosteroids
*Antibiotics, with H. Influenzae coverage*
TEST QUESTION

Antibiotics, with H. Influenzae coverage
Doxycycline
Azithromycin (Zithromax)
Levoflaxacin (Levaquin)
TEST QUESTION

Gold standard diagnosis of Emphysema
pathological specimen
TEST QUESTION

Diagnosis of Emphysema:
Pulmonary Function Testing (PFT), or Spirometry results
FEV1/FVC normal: 80-100%
70-79% borderline
<70%: Emphysema
TEST QUESTION

Non reversible emphysema is not improved with what medication?
not improved with Beta 2
TEST QUESTION

Can you diagnose emphysema with CXR?
no
TEST QUESTION

Common radiographic findings assoc with emphysema:
Hyperinflation of lungs (Blacker: more air)
Increased Anterior-Posterior (AP) diameter
Flattening of the diaphragms
Narrow, more vertical heart
Clinical Findings assoc with emphysema
Thin, cachectic, muscle wasting
Prolonged expiration phase
Breathing through pursed lips
Tripod positioning
Commonly referred to as “Pink Puffers”
#1 Treatment of Emphysema
SMOKING CESSATION
Respiratory function declines with age
Smoker’s rate of decline steeper
Quitting causes rate to return to non-smoker rate
Can regain __% of lost lung function
10
Treatment of Emphysema with meds
(4)
1) Anticholinergic/Beta 2
2) Agonist combination
3) Theophylline (Theodur)
4) Oxygen
Anticholinergic/Beta 2 Agonist combination example
Combivent (Ipratropium/Albertol) 2 puffs QID
Long acting Beta 2 Agonist example
Salmeterol (Serevent) 1 inhalation BID
Oxygen Therapy
Caution: ________ patients
CO2-retaining

Correcting hypoxia, diminishes respiratory drive
TEST QUESTION

Diagnosis of CO2 retainer
blood gas

pH nl/hi,
pCO2 hi,
PO2 low,
HCO3 hi,
SaO2 low
Respiratory acidosis with compensatory metabolic alkalosis
TEST QUESTION

Pulse oximetry only tells about oxygen
DO NOT GET FOOLED, patient gets _____ with oxygen!
worse
Bicarbonate is reported with what confusing label?
CO2
pO2 <__?, oxygen reduces mortality and improves quality of life.
55


continuous therapy
Hypoxia during sleep causes death after PVCs become ventricular _____
arrythmia