Wannamaker 10-4-07 Obstructive Lung Disease

Front 1

Chronic Obstructive Pulmonary Disease (COPD) definition.

comopare to asthma

Back 1

Non-reversible airflow limitation

asthma is reversible

Front 2

Chronic Obstruction of small airways

Back 2

Chronic Bronchitis

Front 3

Destruction of lung parenchyma, loss of lung elasticity, and enlargement of air spaces

Back 3

Emphysema

Front 4

___% of smokers develop COPD

Back 4

14

Front 5

__% of nonsmokers develop COPD

Back 5

3

Front 6

enzyme defici associated with COPD

Back 6

alpha-1 antitrypsin defici

Front 7

TEST QUESTION

Chronic Bronchitis

Definition: Productive cough for _?_ months for 2 years

Back 7

3

Front 8

Chronic Bronchitis:
Commonly referred to as “Blue _____"

Back 8

Bloater

Front 9

Chronic Bronchitis:
Hypersecretion of ____

Back 9

mucous

Front 10

Treatment of Chronic bronchitis

Back 10

MAINSTAY: QUIT SMOKING

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

Front 11

TEST QUESTION

Acute Bacterial Exacerbation of Chronic Bronchitis (ABECB)

Worsening of symptoms (what?)

Back 11

Increased shortness of breath
Change in sputum character (thicker, color change – yellow/green)
Generally, no fever

Front 12

TEST QUESTION

most common etiology of Acute Bacterial Exacerbation of Chronic Bronchitis (ABECB)

Back 12

Haemophilus Influenzae (H. Flu)

Others:
Mycoplasma
M. Catarrhalis

Front 13

Treatment of ABECB

Back 13

Start/continue Anticholinergic
Short acting Beta 2 Agonist
Systemic Corticosteroids
*Antibiotics, with H. Influenzae coverage*

Front 14

TEST QUESTION

Antibiotics, with H. Influenzae coverage

Back 14

Doxycycline
Azithromycin (Zithromax)
Levoflaxacin (Levaquin)

Front 15

TEST QUESTION

Gold standard diagnosis of Emphysema

Back 15

pathological specimen

Front 16

TEST QUESTION

Diagnosis of Emphysema:
Pulmonary Function Testing (PFT), or Spirometry results

Back 16

FEV1/FVC normal: 80-100%
70-79% borderline
<70%: Emphysema

Front 17

TEST QUESTION

Non reversible emphysema is not improved with what medication?

Back 17

not improved with Beta 2

Front 18

TEST QUESTION

Can you diagnose emphysema with CXR?

Back 18

no

Front 19

TEST QUESTION

Common radiographic findings assoc with emphysema:

Back 19

Hyperinflation of lungs (Blacker: more air)
Increased Anterior-Posterior (AP) diameter
Flattening of the diaphragms
Narrow, more vertical heart

Front 20

Clinical Findings assoc with emphysema

Back 20

Thin, cachectic, muscle wasting
Prolonged expiration phase
Breathing through pursed lips
Tripod positioning
Commonly referred to as “Pink Puffers”

Front 21

#1 Treatment of Emphysema

Back 21

SMOKING CESSATION

Front 22

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

Back 22

10

Front 23

Treatment of Emphysema with meds
(4)

Back 23

1) Anticholinergic/Beta 2
2) Agonist combination
3) Theophylline (Theodur)
4) Oxygen

Front 24

Anticholinergic/Beta 2 Agonist combination example

Back 24

Combivent (Ipratropium/Albertol) 2 puffs QID

Front 25

Long acting Beta 2 Agonist example

Back 25

Salmeterol (Serevent) 1 inhalation BID

Front 26

Oxygen Therapy
Caution: ________ patients

Back 26

CO2-retaining

Correcting hypoxia, diminishes respiratory drive

Front 27

TEST QUESTION

Diagnosis of CO2 retainer

Back 27

blood gas

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

Front 28

TEST QUESTION

Pulse oximetry only tells about oxygen
DO NOT GET FOOLED, patient gets _____ with oxygen!

Back 28

worse

Front 29

Bicarbonate is reported with what confusing label?

Back 29

CO2

Front 30

pO2 <__?, oxygen reduces mortality and improves quality of life.

Back 30

55


continuous therapy

Front 31

Hypoxia during sleep causes death after PVCs become ventricular _____

Back 31

arrythmia