COPD

Question 1

What is COPD

Answer 1

• progressive disase that makes it hard to breathe
• not cured but can be prevented and treated

Question 2

what can COPD cause

Answer 2

• Wheezing
• SOB
• chest tightness
• coughing the produces large amounts of mucus

Question 3

What can cause COPD

Answer 3

• cigarette smoking (leading cause)
• long term exposure to other irritants (polution, chemical fumes or dusts etc)
• rare genetic condition called alpha-1 antitrypsin deficiency

Question 4

risk factors for COPD

Answer 4

• smoking/second hand smoke
• lung irritants
• family history
• history of respiratory infections as a child

Question 5

What combinations of diseases overlap with COPD/are COPD disorders

Answer 5

• Chronic bronchitis
• emphysema
• asthma

Question 6

Pathogenesis of COPD

Answer 6

• air movement in the lungs comes in forcefully and with increased pressure
• air movement out of the lungs is not as forceful and therefore bronchial walls collapse causing air trappings

Question 7

Obstruction can occur with

Answer 7

• inflammation of air airways
• bronchial tone/spasm
• weakening or support structures
• alveolar destruction
• lack of surfactant
• retained secretions

Question 8

Normal FEV vs COPD FEV

Answer 8

• should be able to breathe out 75% of air within 1 sec
• takes those with COPD longer

Question 9

Lung volumes and capacities with COPD

Answer 9

• increased RV
• increased TLC

Question 10

Radiographic signs of COPD

Answer 10

• wider AP diametes
• AP ratio is 1:1 (normal 2:1)
• enlarged heart (due to right side overworking)

Question 11

Common characteristics of COPD

Answer 11

• Dyspnea,
• chronic cough
• hypoxia with or without hypercapnia
• alveoli that are narrow and less flexible
• radiographic and functional changes to thorax
• spirometry changes
• pulmonary HTN which can lead to right heart failure
• can be septic or non-septic (both also prone to infection)
• weakness, muscule atrophy, osteoporosis related to decreased mobility becuase of disease
• cognitive impairment, anxiety, depression

Question 12

Non-septic COPD

Answer 12

• Emphysema
• Chronic bronchitis
• possibly chronic asthma

Question 13

Asthma

Answer 13

• meets general criteria but it is reversible
• hyperreactive airway that causes inflammatory response
• bronchioles can remodle
• exercise induced: can occur hours after due to loss of water and heat in the lower respirtoary system
• can hear wheezes
• higher rate in females
• usually mothers side/smoked during pregancy

Question 14

Treatments for asthma

Answer 14

• ask if they use inhlater before an dafter sport
• short term inhalers and long term inhalers
• often times a mixture of smooth muscule dilators and anti-inflammatory medication
• can also use nebulizer

Question 15

Emphysemia

Answer 15

• damaged alveoli
• loss of surface are for gas exchnage
• breakdown areas = bullae

Question 16

Alpha-1 antitrypin deficiency: genetically acquired emphysema

Answer 16

• AAT is a protein that is made in the liver
• inhibites elastace which breaks down lung tissue
• deficiency leads to breakdown of tissue in lungs and liver dysfunction
• breakdown can be accelerated in those who smoke
• can also lead to liver cirrhosis

Question 17

Chronic bronchitis

describe

Answer 17

• comes back very year or every so often
• long term inflammation of epithelium,
• enlarged submucusal gland/mucus accumulation
• hyperinflation of alveoli
• damaged cilia

Question 18

Septic obstructive pulmonary diseases

Answer 18

• Cystic fibrosis
• bronchiectasis

Question 19

Cyctis fibrosis

Answer 19

• genetic defect in lungs,
• excessive production of thickened dehydrated hyperviscous mucus

Question 20

Organs affected by cystic fibrosis

Answer 20

• Sinuses (infection)
• lungs: thick sticky mucus buildup, bacterial infection and widened airways
• skin: sweat glands produce salty sweat (can be diagnositic )
• pacrease: blocked pancreatic ducts
• intestines: cannot fully absorb nutrients
• reporductive organs: problems with fertility or delyaed puberty

Question 21

Bronchiectasis

Answer 21

• flabby airways with mucus hypersecretion
• weak wall causes collapse with exhale

Question 22

GOLD classification system

Answer 22

• Group a: low symptoms/risk, mMRC 0-1; >50% FEV, 0-1 outpatient or 0 hopsitalized excaerbation
• Group B: high symptoms/low risk, mMRC 2-4, >50% FEV, 0-1 outpatient or 0 hopsitalized exacerbations
• Group C: low symptoms, High risk, mMRC 0-1, <50% FEV, >2 outpatinet or >1 hospitalized exacerbations
• Group d: High symptoms, High risk, mMRC 2-4, <50% FEV, >2 outpatient or >1 hospitalized exacerbations

dont memorize but look over

Question 23

What to watch for with COPD both septic and non-septic

Answer 23

• increase cough or sputum production above normal
• increased body temp
• increased respiratory rate above patient norm
• changes in X-ray, auscultation, ABGs, PFTs
• Decreased appetite, weight activity levels

Question 24

Treatment for COPD

As severity increases (least severe to most)

Answer 24

• self management education and smoking cessation
• bronchodilators
• inhaled corticosteriods
• pulmonary rehabilitation
• oxygen
• surgery

Question 25

Medications for COPD

Answer 25

- bronchodilators: short or long acting - Corticosteriods - mucolytic agents - antibiotics - oxygen

Question 26

Physical therapy for COPD

Answer 26

- breathing exercises - chest mobility, posture, shoulder ROM - postural drainage - bronchial hygiene techniques when neeeded (precussion/vibration/cough. huff) - aerobic/strength conditioning - relaxation training

Question 27

surgical options for COPD

Answer 27

- bullectomy: can remove a portion - lung volume reduction (segment or lobe remove) - lobectomy - transplant