Current Medical Diagnosis and Treatment p 245-268
(Pulmonary disorders) Questions and Answers| Latest
Update 100% Verified
The initial drug of choice for patients with mild COPD disease and no exacerbations is LAMA:
Tiotropium
If a patient has more severe COPD dyspnea and airflow obstruction a __________ can be
added? LAMA/LABA
LAMA: tiotropium
LABA: formoterol, salmeterol
COPD is generally not responsive to ____________ therapy? Oral steroid therapy
GOLD guidlines recommend ________ as a last resort if other bronchodilators are unavailabe
for treatment of COPD Theophyline
Indications for antibiotic treatment in patients with COPD 1. Treat acute exacerbation
2. Treat acute bronchitis
3. Prevent acute exacerbations of chronic bronchitis
Oral antibiotic options for treatment of COPD Doxycycline 100mg q12
Bactrim 160/800 q12
Cefpodoxime
macrolide
Flouroquinolone
,Augmentin
Duration of therapy is 3-5 days
which PDE-4 inhibitor is shown to reduce exacerbation frequency in COPD Roflumilast
What is availabe for replacement therapy due to congenital deficiencyin COPD Human
Alpha-1-antitrypsin
_________ can marginally improve the intractable dyspnea in patients with COPD Opioids
(morphine
Hospitalized patients with COPD require 1. Oxygen (maintain SPO2 90-94)
2. Albuterol
3. Steroids
4. Antibiotics
5. Chest physiotherapy
Procedures available for COPD 1. Lung transplant (requires severe lung disease, limited
ADL's, exhaustion of medical therapy, ambulatory status, potential for pulmonary rehab, life
expectancy, adequate function of other organ systems)
2. Lung volume reduction surgery (involves removal of 20-30% of lung volume)
3. Bullectomy (most commonly pursued when a single bulla occupies at least 30-50% of
hemithorax)
What index predicts death and hospitalization better than FEV1 in patients with COPD BODE
B: BMI
O: Obstruction (FEV1)
, D: Dyspnea
E: Exercise capacity
Bronchiectasis is Permanent, abnormal dilation and destruction of bronchial walls
50% of bronchiectasis is caused by Cystic fibrosis
Signs of Symptoms of bronchiectasis -chronic cough, productive foul-smelling sputum
-often begins after infection
- hemoptysis
- pleuritic chest pain
- dyspnea
- weight loss
Hallmark test of cystic fibrosis Sweat chloride level
Mutation of CFTR gene
MC bacteria of Bronchiectasis H flu, Pseudomonas, Strep pneumo, Staph
Treatment of acute exacerbations of bronchiectasis include Antibiotics
Airway clearance (postural drainage, chest percussion, hypertonic nebulation
Inhaled bronchodilators
Pulmonary disorder caused by allergy to fungal antigens that colonize the tracheobronchial tree
Allergic bronchopulmonary aspergillosis
(Pulmonary disorders) Questions and Answers| Latest
Update 100% Verified
The initial drug of choice for patients with mild COPD disease and no exacerbations is LAMA:
Tiotropium
If a patient has more severe COPD dyspnea and airflow obstruction a __________ can be
added? LAMA/LABA
LAMA: tiotropium
LABA: formoterol, salmeterol
COPD is generally not responsive to ____________ therapy? Oral steroid therapy
GOLD guidlines recommend ________ as a last resort if other bronchodilators are unavailabe
for treatment of COPD Theophyline
Indications for antibiotic treatment in patients with COPD 1. Treat acute exacerbation
2. Treat acute bronchitis
3. Prevent acute exacerbations of chronic bronchitis
Oral antibiotic options for treatment of COPD Doxycycline 100mg q12
Bactrim 160/800 q12
Cefpodoxime
macrolide
Flouroquinolone
,Augmentin
Duration of therapy is 3-5 days
which PDE-4 inhibitor is shown to reduce exacerbation frequency in COPD Roflumilast
What is availabe for replacement therapy due to congenital deficiencyin COPD Human
Alpha-1-antitrypsin
_________ can marginally improve the intractable dyspnea in patients with COPD Opioids
(morphine
Hospitalized patients with COPD require 1. Oxygen (maintain SPO2 90-94)
2. Albuterol
3. Steroids
4. Antibiotics
5. Chest physiotherapy
Procedures available for COPD 1. Lung transplant (requires severe lung disease, limited
ADL's, exhaustion of medical therapy, ambulatory status, potential for pulmonary rehab, life
expectancy, adequate function of other organ systems)
2. Lung volume reduction surgery (involves removal of 20-30% of lung volume)
3. Bullectomy (most commonly pursued when a single bulla occupies at least 30-50% of
hemithorax)
What index predicts death and hospitalization better than FEV1 in patients with COPD BODE
B: BMI
O: Obstruction (FEV1)
, D: Dyspnea
E: Exercise capacity
Bronchiectasis is Permanent, abnormal dilation and destruction of bronchial walls
50% of bronchiectasis is caused by Cystic fibrosis
Signs of Symptoms of bronchiectasis -chronic cough, productive foul-smelling sputum
-often begins after infection
- hemoptysis
- pleuritic chest pain
- dyspnea
- weight loss
Hallmark test of cystic fibrosis Sweat chloride level
Mutation of CFTR gene
MC bacteria of Bronchiectasis H flu, Pseudomonas, Strep pneumo, Staph
Treatment of acute exacerbations of bronchiectasis include Antibiotics
Airway clearance (postural drainage, chest percussion, hypertonic nebulation
Inhaled bronchodilators
Pulmonary disorder caused by allergy to fungal antigens that colonize the tracheobronchial tree
Allergic bronchopulmonary aspergillosis
