Term
| 4 characteristics of COPD |
|
Definition
| chronic bronchitis, emphysema, small airway disease, vascular remodeling |
|
|
Term
| __% of COPD pts smoke; __% of smokers will develop COPD |
|
Definition
|
|
Term
| 1% of COPD pts have this defect and present with hepatomegaly and cirrhosis |
|
Definition
| alpha1 antitrypsin deficiency |
|
|
Term
| serpin that inhibits PMN elastase |
|
Definition
|
|
Term
| 3 environmental hazards that predispose you to COPD |
|
Definition
| biomass fuels, occupational hazards, air pollution |
|
|
Term
| COPD pathogenesis: Th1/Th2? innate/acquired? |
|
Definition
|
|
Term
| effect of smoke and inflammation on antiproteases |
|
Definition
| both inhibit antiproteases |
|
|
Term
| effects of oxidative stress (5) |
|
Definition
| oxidation of enzymes and structural proteins, lipid peroxidation, chromatin remodeling, increases mucus secretion, increases PMNs |
|
|
Term
| COPD prevalence in adults worlwide |
|
Definition
|
|
Term
| COPD on respiratory mechanics (4) |
|
Definition
| air trapping, dynamic hyperinflation, static hyperinflation, reduced expiratory flow rates |
|
|
Term
| causes of airway obstruction in COPD (2) |
|
Definition
| emphysema (collapse of bronchioles), chronic bronchiolitis (mucus secretion) |
|
|
Term
| definition of a significant response to bronchodilators |
|
Definition
| FEV1 or FVC >12% or >200ml post-BD |
|
|
Term
| 3 causes of airway hyperresponsiveness |
|
Definition
| increased vagal tone, chronic inflammation, smooth m. contraction |
|
|
Term
| why does the work of inspiration increase in COPD? |
|
Definition
| flat diaphragm (low mechanical advantage), ventilating at lower compliance, and reduced operating length of muscle |
|
|
Term
| 4 causes of hypercapnia in COPD |
|
Definition
| cannot maintain hyperventilation, innately less sensitive to CO2 changes, loss of lung parenchyma, more obstruction |
|
|
Term
| 3 causes of pulmonary HTN in COPD |
|
Definition
| fibrosis and remodeling, reflex vasoconstriction, loss of parenchyma |
|
|
Term
| sleep disorders associated with COPD |
|
Definition
| hypopnea; nocturnal SaO2 drop determines daytime hypoxemia |
|
|
Term
|
Definition
| interstitial pulmonary fibrosis |
|
|
Term
| coarse crackles, occasional; dx? |
|
Definition
|
|
Term
| coarse crackles, persistent; dx? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| bronchovesicular, wheezing, rhonchi, coarse occasional crackles |
|
|
Term
| differential diagnosis of obstructive intrapulmonary airways |
|
Definition
| asthma, emphysema, chronic bronchitis, bronchiectasis; CHF, TB |
|
|
Term
| differential for chronic hypercapnia |
|
Definition
| neuromuscular disease, morbid obesity, metabolic acidosis, sleep apnea |
|
|
Term
| rate of FEV1 decline in smokers vs. non-smokers |
|
Definition
| 20-30ml/yr in nonsmokers; 50-100ml/yr in smokers |
|
|
Term
| #1 cause of LRI in COPD pts |
|
Definition
|
|
Term
| #1 cause of pneumoniae in COPD pts |
|
Definition
|
|
Term
| #1 cause of acute exacerbation in COPD pts |
|
Definition
| infection of tracheobronchial tree |
|
|
Term
| what therapy for COPD is the only one proven to improve mortality? |
|
Definition
|
|
Term
|
Definition
| measure FEV1 every 1-3years for smokers |
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