Term
A common, preventable, treatable disease characterized by persistent airflow limitation that is usually progressive |
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Definition
Chronic Obstructive Pulmonary Disease |
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Definition
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Definition
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the presence of permanent enlargement of airspaces distal to the terminal bronchioles, with destruction of their walls, without fibrosis |
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Definition
Chronic productive cough for 3 months in each of 2 successive years after other causes of cough are ruled out |
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Definition
Inhalation of noxious particles/gases; Pathologic changes in 4 lung compartments; Physiologic abnormalities |
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Inhalation of noxious particles/gases |
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Definition
Inflammation (diff. than asthma); imbalance of proteinases and anti-proteinases; oxidative stress; genetic component |
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Term
Pathologic changes in 4 lung compartments |
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Definition
Central airways, peripheral airways, lung parenchyma, pulmonary vasculature |
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Definition
goblet cell hypertrophy, enlarged submucosal glands, squamous metaplasia of epithelium |
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Definition
airway wall thickening, peribronchial fibrosis, airway narrowing, inflammatory exudates |
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Definition
abnormal permanent enlargement of the airspaces distal to the terminal bronchiole, loss of alveolar attachments |
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Definition
intimal thickening, endothelial dysfunction, smooth muscle hypertrophy |
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Physiologic abnormalities |
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Definition
mucous hypersecretion, ciliary dysfunction; Airflow limitation, hyperinflation; gas exchange abnormalities; pulmonary hypertension,; systemic effects |
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Term
Mucous hypersecretion, ciliary dysfunction |
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Definition
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Term
Airflow limitation, hyperinflation |
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Definition
expiratory, largely irreversible, measured by spirometry, hallmark of COPD |
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Term
Gas exchange abnormalities |
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Definition
occur in advanced disease |
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Definition
skeletal muscle wasting, systemic inflammation |
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Airway remodeling, loss of elastic recoil, destruction of alveolar support, inflammatory exudates in airways, smooth muscle contraction, dynamic hyperinflation during exercise |
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Definition
Airflow limitation, hyperinflation |
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Term
Hypoxemia with/without hypercapnea, due to ventilation/perfusion alterations |
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Definition
gas exchange abnormalities |
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hypoxic vasoconstriction, endothelial dysfunction, pulmonary arterial remodeling, loss of alveolar capillary bed, may lead to right ventricular hypertrophy and right heart failure (Cor Pulmonale) |
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Definition
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general treatment principles |
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Definition
reduce symptoms, reduce risk |
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Components of COPD Management |
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Definition
1) Assess and Monitor Disease 2) Reduce Risk Factors 3) Manage Stable COPD 4) Manage Exacerbations |
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Term
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Definition
Confirmed by an objective measure of airflow limitation-- spirometry; Post-bronchodilator FEV1/FVC less than 0.7 indicates airflow limitation that is not fully reversible |
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Term
progressive, persistent, worse with exercise |
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Definition
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may be intermittent and non-productive |
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Definition
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any pattern may indicate COPD |
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Definition
chronic sputum production |
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Term
tobacco smoke, occupational exposure, smoke from home cooking/heating oils |
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Definition
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FEV1 % predicted at least 80 |
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breathlessness measurement using the modified British Medical Research Council questionnaire |
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Definition
COPD assessment test, measure of health status impairment |
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Definition
history of exacerbations is best predictor of future events |
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Term
Low risk, less symptoms (GOLD 1-2) |
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Definition
Category A; 1 or less exacerbations per year |
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Low risk, more symptoms (Gold 1-2) |
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Definition
Category B; 1 or less exacerbations per year |
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High risk, less symptoms (Gold 3-4) |
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Definition
Category C; 2 or more exacerbations per year |
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Term
High risk, more symptoms (Gold 3-4) |
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Definition
Category D; 2 or more exacerbations per year |
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mMRC at least 2; CAT at least 10 |
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mMRC at least 2; CAT at least 10 |
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Additional diagnostic studies |
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Definition
chest x-ray; arterial blood gases, electrocardiogram; hemoglobin/hematocrit;alpha1 antitrypsin levels; bronchodilator/steroid reversibility testing |
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Definition
smoking cessation, minimize occupational exposures, indoor/outdoor air pollution, immunizations |
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can reduce serious illness and death |
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Definition
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benefits less clear, decrease pneumonia |
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Definition
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Term
Persistent airflow limitation in COPD |
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Definition
vs. intermittent obstruction in asthma |
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Term
dramatic beta-agonist response in asthma |
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Definition
vs. moderate response in COPD |
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