Basics & Risk Factors
PFTs and GOLD Criteria
Emphysema Vs Chronic Bronchitis
Treatment Ladder
Exacerbations and Oxygen Therapy
100
The #1 risk factor for COPD in US?
Smoking
100
The best test to confirm COPD.
Spirometry
100
"Pink-Puffer"
Emphysema
100
First-line rescue inhaler?
SABA (Albuterol)
100
Respiratory Acidosis is defined as a pH below ____, and is an indication for non-invasive mechanical ventilation.
<7.35
200
The Genetic deficiency that leads to early emphysema
Alpha-1 antitrypsin deficiency
200
Which subtype of COPD has decreased DLCO? (Diffusion Capacity of the lungs for Carbon Monoxide)
Emphysema
200
"Blue-Bloater"
Chronic Bronchitis
200
First long-term therapy for symptomatic COPD?
LAMA or LABA
200
The most common trigger for a COPD Exacerbation.
Viral Upper Respiratory Infection
300
The type of airflow limitation that COPD is.
Obstructive
It is persistent, not fully reversible
300
A Pre and Post Bronchodilator Spirometry finding of FEV1/FVC <____ is diagnostic of COPD.
0.7
300
Chronic cough ≥3 months × 2 years
Chronic Bronchitis
300
Triple therapy includes which classes of inhaled medications?
LABA + LAMA + ICS
300
Outpatient management of COPD exacerbations includes intensifying bronchodilator therapy, and in some patients, initiating a course of ____________, such as Prednisone 40 mg for 5 days, and/or oral antibiotics.
Oral Glucocorticoids
Can use the Rome classification criteria for COPD exacerbation severity in an outpatient setting.
400
The sputum color in COPD is typically:
Off-white, yellow or tan.
Unlike in Asthma, which is typically clear and transparent.
400
The GOLD Criteria categorizes COPD severity into different groups based on ________.
FEV1 % Predicted
Used for Prognosis, risk counseling, and overall assessment.
400
CT findings in emphysema
Hyperinflation & Bullae
400
If a COPD Patient has eosinophils > 300 or at least one exacerbation that leads to a hospitalization, we begin treatment with what class of inhaled medication?
ICS
400
The O2 saturation threshold for Long Term Oxygen Therapy in COPD patients is:
SPO2 <88% or PaO2 ≤55
500
2 vaccines that decrease COPD hospitalizations and death
Influenza and Pneumococcal
COVID 19, RSV, pertussis, and shingles vaccines may be appropriate based on age and comorbidities.
500
According to the 2024 GOLD report, treatment is based on the patient's __________ and ___________ history (Groups A/B/E).
Symptoms and Exacerbation history
500
More likely to develop cor pulmonale?
Chronic Bronchitis
Hypoxia -> Reflex pulmonary vasoconstriction -> pulmonary hypertension -> Right heart failure (cor pulmonale) -> edema
500
This medication can be used in patients with severe COPD (FEV1 <50%) and exacerbations despite treatment with LABA +LAMA + ICS therapy.
Roflumilast
Roflumilast is a long-acting inhibitor of Phosphodiesterase type 4, which leads to the inhibition of the breakdown of intracellular cAMP.
500
Why avoid high-flow O2 in COPD?
Risk of hypercapnia (blunts hypoxic drive + V/Q mismatch)