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COPD
PA CLin Med
49
Health Care
Graduate
09/19/2009

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Cards

Term
3 types of COPD
Definition
1. chronic bronchitis
2. Emphysema
3. Asthma
Term
a chronic productive cough for 3 months in 2 consecutive yrs in a patient whom other causes of chronic cough have been excluded achieves a Dx of:
Definition
Chronic Bronchitis
Term
abnormal and permanent enlargement of the airspaces that are distal to the terminal bronchioles:
Definition
emphysema
Term
chronic inflammatory disorder of the airways in which many cells and cellular elements play a role
Definition
asthma
Term
is the death rate from COPD rising or falling?
Definition
rising; doubled every 5 yrs in the past 2 decades
Term
Etiology of COPD
Definition
chronic exposure to irritants; tobacco smoke, pollution, infections. genetic def in alpha1antitrypsin is major contributor but does not have to be present
Term
In the bronchitic component of COPD name 4 elements that contribute to airway narrowing:
Definition
1. mucus plugging from mucus gland hyperplasia
2. inflammation (chronically leading to:)
3. fibrosis &
4. edema
Term
in the emphysema component of COPD what contributes to airway narrowing?
Definition
loss of tissue support; structure is degraded from elastase activity
Term
what about emphysema would produce dilated air spaces?
Definition
destruction of alveolar septum producing one large alveolar sack
Term
abnormal weakening & enlargement of all air spaces distal to terminal bronchioles
Definition
panlobar or panacinar emphysema
Term
panlobar or panacinar emphysema is cased by:
Definition
a-1-AT deficiency
Term
define acinar/acinus
Definition
alveolus
Term
Most common form of emohysema: it is assoc w:
Definition
centrilobar or centricinar emphysema is associated with chronic bronchitis
Term
centirlobar or centricinar emphysema primarily involves the _________ ________ as opposed to panlobar wich involves ________ ________.
Definition
centrilobar involes the respiratory bronchioles and panlobar invlolves everything distal to the terminal bronchioles
Term
blue bloater:
Definition
chronic bronchitis
Term
what is the major complaint of a "blue bloater"
Definition
major complaint is chronic productive cough
Term
7 clinical presentations of a blue bloater:
Definition
1. overweight, cyanotic
2. chronic productive cough
3. late 30's/40's
4. mild dyspnea
5. comfortable at rest
6. "Noisy" chest - wheezing
Term
pink puffer:
Definition
emphysema
Term
what is the major complaint of a pink puffer?
Definition
dyspnea
Term
is cough a common complaint in pink puffers?
Definition
no
Term
what age are pink puffers
Definition
>50
Term
what are breath sounds assoc with pink puffers?
Definition
quiet; nobreath sounds
Term
describe the physical appearance of an emphysema patient:
Definition
>50, thin (evidence of weight loss), no peripheral edema, barrel chest, struggles to breath
Term
5 key indicators for COPD Dx:
Definition
1. chronic cough
2. chronic sputum production
3. dyspnea
4. repeated episodes of acute bronchitis
5. Hx of exposure to risk factors
Term
halmark finding in CXR of emphysema:
Definition
flattened diaphragm
Term
increased interstitial markings in CXR (dirty lungs)
Definition
chroinic bronchitis
Term
ABG on chronic bronchitis show:
Definition
PCO2
Term
H&H on chronic bronchitis shows:
Definition
elevation
Term
PFT in chronic bronchitis shows:
Definition
epiratory flow obstruction
Term
HH in emphysema =
Definition
normal
Term
ABG in emphysema shows:
Definition
more normal PO2 & PCO2
Term
emphysema CXR shows:
Definition
flattened diaphragm, hyperinflation (air is black, decreased vascular markings
Term
PFT in emphysema shows:
Definition
epiratory flow obstruction
Term
measurement used for Dx, prognosis, severity assesment & monitoring progression
Definition
spirometry
Term
what 3 spirometry values are we interested in?
Definition
FEV1, FVC, FEV1:FVC
Term
which medications are central to the management of COPD?
Definition
bronchodilators
Term
3 classes of bronchodilators:
Definition
1. beta2 agonists
2. anti-cholinergics
3. methylxanthines
Term
suffix for beta2 agonists:
Definition
ol (salmeterol)
Term
suffix for anticholinergics:
Definition
pium (ipatropium)
Term
suffix for methylxanthines:
Definition
lline (theophylline)
Term
in addition to bronchodilators, __________ are recommended for stage III/IV COPD.
Definition
glucocorticoids
Term
most COPD exacerbations are due to:
Definition
infection
Term
which 2 vaccines may prevent exacerbations?
Definition
pneumococcal and influenza
Term
productive cough, hypoxia, hypercapnea, edema, smoker, cor pulmonale:
Definition
chronic bronchitis
Term
hypercapnea, >mucus, SOB, wheezing, frquent URIs, prolonged expiration, ineffective cough
Definition
emphysema
Term
FEV1 >80%: Tx:
Definition
stage I COPD, avoid risk factors, vaccine, short acting bronchodilator
Term
FEV1 <30%, Tx
Definition
stage IV COPD (very severe), long term O2 therapy, surgery, corticosteroid, bronchodilator
Term
stage II FEV1
Definition
50-80% post dilator
Term
stage III COPD FEV1 post dilator:
Definition
30-50%
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