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CPR II Exam 2 > Asthma and COPD > Flashcards

Flashcards in Asthma and COPD Deck (24)
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1

What are prenatal risk factors for asthma?

ethnicity 

low SES

stress

C-section

maternal smoking

prematurity 

2

What are postnatal risk factors for asthma

allergens

viral/bacterial infections

pollution

abx use

tylenol use

obesity 

3

How is an asthma diagnosis made?

 

 

Does normal spirometry rule out asthma?

12% improvement in FEV1 over baseline and a total improvement of at least 200ml 

AKA reversibility of airway obstruction 

 

No 

4

What qualifies as mild asthma?

symptoms >2 days/week but not daily 

night time wakenings 1-2xmonth to 3-4xmonth 

exacerbations requiring corticosteroids >2 in 6 months or wheezing >4x per year lasting >1 day and risk factors for persistent asthma 

5

What qualifies as moderate asthma?

SABA use daily with some limitation in daily activities 

6

What qualifies as severe asthma?

SABA use several times per day, extremely limited in daily acitivities 

7

What is the goal of ashtma management?

provide the best QOL through minimizing disease sx and abolishing exacerbations 

8

What are exacerbations caused by?

Best way to treat asthma exacerbations?

infections, allergens 

Prevention, bronchodilators, glucocorticoids, O2

9

How to prevent asthma?

breastfeeding

avoid tobacco smoke

target obestiy

balanced diet, Vit. D

allergy avoidance?

Gut microbiome?

vaccinations 

10

What is COPD?

persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles and gases 

 

It is largely irreversible

11

What are the common causes of COPD?

smoking

hx of TB 

pollution?

likely genetic deficiency, esp. A1A deficiency 

12

What are the symptoms of COPD?

dyspnea

sputum

cough

wheezing

 

13

What are some comorbidies associated with COPD?

CAD

arrhythmias 

HTN

HF

Lung Ca 

depression/anxiety

metabolic syndrome

osteoporosis 

14

What are the "Pink Puffers" 

more emphysema

lower BMI

fewer heart problems/comorbidities

hyperinflation, lower diffusion for CO

more dyspnea

worse health status 

 

15

What are the "Blue Bloaters" 

higher BMI

more co-morbidities/heart problems 

OSA-COPD overlap

less hyperinflation 

more chronic bronchitis, less emphysema 

more diffusion capacity

higher IL6, CRP

16

What are the spirometry findings for COPD?

FEV1/FVC <.70>

Low FEV1

<12% reversibility 

17

What are the goals of COPD management?

reduce sx, prevent disease progression 

Send to pulmonary rehab 

consider lung volume reduction surgery and transplantation 

18

What is the mainstay of treatment for COPD?

bronchodilators 

LAMA+LABA increase lung function 2x (not nec. sx) 

19

In which patients are inhaled corticosteroids used in COPD management?

for those at high risk of exacerbations

improves lung function but increases risk for PNA, thrush, etc. 

20

What is the benefit of using oxygen therapy in patients with COPD?

REDUCES MORTALITY

(Used at least 15hrs if SaO2 is <88%) 

21

 

what is the initial management of COPD?

smoking cessation

vaccination 

encourage xercise 

patient education 

manage co-morbidities 

22

Inhaled corticosteroids are indicated for COPD pt's when?

 

 

Consider ICS when?

 

Stop ICS when?

history of exerbation requiring hospital stay, >2 exerbations per year, blood eosinophils >300, hx of asthma 

 

1 exacerbation per year, eosinophils 100-300

 

repeated PNA, eosinophils <100, mycobacterial infection

23

What is the mainstay of COPD treatment for acute exacerbations?

Oral corticosteroids

 

consider abx and oxygen if needed 

24

prevent COPD exacerbations how?

flu and pneumococcal vaccine 

long acting bronchodilators and ICS 

consider mucolytics