Chronic Obstructive Pulmonary Disease (COPD) Questions & Answers

Updated: Apr 05, 2019
  • Author: Zab Mosenifar, MD, FACP, FCCP; Chief Editor: John J Oppenheimer, MD  more...
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Questions & Answers

Overview

What is chronic obstructive pulmonary disease (COPD), and how common is it in the US?

What are the signs and symptoms of chronic obstructive pulmonary disease (COPD)?

What signs of chronic obstructive pulmonary disease (COPD) are observed in a thoracic exam?

Which characteristics differentiate chronic bronchitis and emphysema in patients presenting with chronic obstructive pulmonary disease (COPD)?

Which office test is used to diagnose chronic obstructive pulmonary disease (COPD), and what are the stages?

How are arterial blood gas (ABG) findings used to determine acuteness and severity of chronic obstructive pulmonary disease (COPD)?

Which type of chest radiographs are used in patients with emphysema associated with chronic obstructive pulmonary disease (COPD), and what are the findings?

What are the advantages of high-resolution CT scanning in the diagnosis of chronic obstructive pulmonary disease (COPD)?

In addition to spirometry and imaging, what additional tests that can be used in the diagnosis of chronic obstructive pulmonary disease (COPD)?

What are the management strategies for each stage of chronic obstructive pulmonary disease (COPD)?

Which drugs are used to treat chronic obstructive pulmonary disease (COPD)?

What are the elements of a pulmonary rehabilitation program in chronic obstructive pulmonary disease (COPD) management?

When is hospitalization indicated in patients with chronic obstructive pulmonary disease (COPD)?

How common is chronic obstructive pulmonary disease (COPD) in the US, and which conditions are included in the classic triad of COPD?

How has our understanding of chronic bronchitis and emphysema in chronic obstructive pulmonary disease (COPD) evolved?

How do the GOLD guidelines define chronic obstructive pulmonary disease (COPD)?

Which types of medications are used in the treatment of chronic obstructive pulmonary disease (COPD)?

What is the pathophysiology of emphysema in chronic obstructive pulmonary disease (COPD)?

What is the pathogenesis of chronic obstructive pulmonary disease (COPD)?

What is the pathophysiology of chronic bronchitis in chronic obstructive pulmonary disease (COPD)?

What are the roles of emphysematous destruction and small airway inflammation in chronic obstructive pulmonary disease (COPD) pathophysiology?

What is the role of dynamic hyperinflation in chronic obstructive pulmonary disease (COPD) pathophysiology?

What is the role of cigarette smoking in chronic obstructive pulmonary disease (COPD)?

Which environmental factors contribute to the development of chronic obstructive pulmonary disease (COPD)?

What is the role of airway hyperresponsiveness (Dutch hypothesis) in the development of chronic obstructive pulmonary disease (COPD)?

What is alpha1-antitrypsin (AAT), and what is its role in the development of chronic obstructive pulmonary disease (COPD)?

How does IV drug use contribute to the development of chronic obstructive pulmonary disease (COPD)?

What is the role of immunodeficiency syndromes in the development of chronic obstructive pulmonary disease (COPD)?

Which inflammatory processes are associated with chronic obstructive pulmonary disease (COPD)?

Which connective tissue disorders are associated with the development of chronic obstructive pulmonary disease (COPD)?

What is Salla disease, and how is it associated with the development of chronic obstructive pulmonary disease (COPD)?

How prevalent are emphysema and chronic bronchitis in the US, and why is the prevalence of chronic obstructive pulmonary disease (COPD) likely underestimated?

What is the worldwide prevalence of chronic obstructive pulmonary disease (COPD)?

Is chronic obstructive pulmonary disease (COPD) more common in men or women?

What is the prevalence of chronic obstructive pulmonary disease (COPD) in patients with a history of smoking?

What is the mortality rate associated with chronic obstructive pulmonary disease (COPD)?

What is the BODE index, and how is used to estimate the prognosis of chronic obstructive pulmonary disease (COPD)?

Are questionnaires effective in assessing quality of life in patients with chronic obstructive pulmonary disease (COPD)?

What are the risk factors for mortality in patients with chronic obstructive pulmonary disease (COPD)?

What can patients do to actively manage their chronic obstructive pulmonary disease (COPD)?

Presentation

When do patients with chronic obstructive pulmonary disease (COPD) typically seek treatment, and which signs and symptoms are observed at presentation?

According to the COPD guidelines, what 3 signs indicate airflow obstruction in patients presenting with chronic obstructive pulmonary disease (COPD)?

How does chronic obstructive pulmonary disease (COPD) progress, and which comorbidities contribute to mortality?

What is the role of chronic obstructive pulmonary disease (COPD) in mild cognitive impairment (MCI)?

How can the clinical and historical findings be used to differentiate the types of chronic obstructive pulmonary disease (COPD)?

Which respiratory findings in a patient with chronic obstructive pulmonary disease (COPD) are associated with severe disease?

How do the characteristics of chronic bronchitis and emphysema differ in chronic obstructive pulmonary disease (COPD)?

What is the GOLD criteria for staging chronic obstructive pulmonary disease (COPD), and what other staging systems are used in COPD?

DDX

How is congestive heart failure (CHF) differentiated from chronic obstructive pulmonary disease (COPD)?

How is bronchiectasis differentiated from chronic obstructive pulmonary disease (COPD)?

How is bronchiolitis obliterans distinguished from chronic obstructive pulmonary disease (COPD)?

How is adult-onset asthma distinguished from chronic obstructive pulmonary disease (COPD)?

What are the differential diagnoses for Chronic Obstructive Pulmonary Disease (COPD)?

Workup

What is the defining feature of chronic obstructive pulmonary disease (COPD)?

How is the formal diagnosis of chronic obstructive pulmonary disease (COPD) made?

Are blood-based biomarkers used in the diagnosis of chronic obstructive pulmonary disease (COPD)?

Why is chronic obstructive pulmonary disease (COPD) underdiagnosed in its early stages?

How is arterial blood gas (ABG) analysis used to determine the acuteness and severity of chronic obstructive pulmonary disease (COPD)?

How is pH level used to assess respiratory compromise in chronic obstructive pulmonary disease (COPD)?

Which electrolyte levels should be monitored in patients with chronic obstructive pulmonary disease (COPD)?

What is the role of alpha1-antitrypsin (AAT) testing in the workup of chronic obstructive pulmonary disease (COPD)?

What are the characteristics of sputum in chronic obstructive pulmonary disease (COPD)?

How does B-type natriuretic peptide (BNP) bind?

What is the role of B-type natriuretic peptide (BNP) levels in evaluating chronic obstructive pulmonary disease (COPD) exacerbations?

What do chest radiographs demonstrate in patients with severe chronic obstructive pulmonary disease (COPD)?

How is high-resolution CT (HRCT) scanning used in patients with chronic obstructive pulmonary disease (COPD)?

What are the causes and effects of pulmonary hypertension in patients with chronic obstructive pulmonary disease (COPD)?

What is the role of echocardiography in the diagnosis of chronic obstructive pulmonary disease (COPD)?

What is the role of pulmonary function tests in the workup of chronic obstructive pulmonary disease (COPD)?

How is the 6-minute walking distance (6MWD) test used in the evaluation of patients with chronic obstructive pulmonary disease (COPD)?

What is the role of pulse oximetry in the workup of chronic obstructive pulmonary disease (COPD)?

What is the role of ECG in the workup of chronic obstructive pulmonary disease (COPD)?

When is right-sided heart catheterization indicated in patients with chronic obstructive pulmonary disease (COPD)?

What hematocrit level in chronic hypoxemia indicates polycythemia?

Treatment

How effective is aclidinium in the treatment of chronic obstructive pulmonary disease (COPD)?

How does umeclidinium bromide work in the treatment of chronic obstructive pulmonary disease (COPD), and is it safe and effective?

What is the goal of treatment in chronic obstructive pulmonary disease (COPD), and what options are available?

What is the most effective disease management strategy for chronic obstructive pulmonary disease (COPD)?

When should a patient with chronic obstructive pulmonary disease (COPD) be admitted to an ICU?

What types of medications are used in the treatment of chronic obstructive pulmonary disease (COPD)?

What is the role of nutrition in chronic obstructive pulmonary disease (COPD)?

What is the role of bronchodilators in chronic obstructive pulmonary disease (COPD)?

Which medications are most effective as first-line therapy in the treatment of chronic obstructive pulmonary disease (COPD)?

How do beta2-agonist bronchodilators work to treat chronic obstructive pulmonary disease (COPD), and what are the potential adverse effects?

How do anticholinergic drugs work to treat chronic obstructive pulmonary disease (COPD), and what are the potential adverse effects?

What adverse effects of anticholinergic drugs have been demonstrated in men with chronic obstructive pulmonary disease (COPD)?

What is the preferred method of delivery of medications in the treatment of chronic obstructive pulmonary disease (COPD)?

What are the risks associated with using newly prescribed long-acting beta-agonist and anticholinergic treatments for chronic obstructive pulmonary disease (COPD)?

Is combination or monotherapy more effective in the treatment of chronic obstructive pulmonary disease (COPD)?

How does glycopyrrolate work to treat chronic obstructive pulmonary disease (COPD)?

How does combination glycopyrrolate/formoterol therapy work to treat chronic obstructive pulmonary disease (COPD)?

What long-term maintenance options are available for chronic obstructive pulmonary disease (COPD)?

What is the efficacy of tiotropium in the treatment of chronic obstructive pulmonary disease (COPD)?

What is the efficacy of aclidinium in the treatment of chronic obstructive pulmonary disease (COPD)?

What is the efficacy of umeclidinium bromide in the treatment of chronic obstructive pulmonary disease (COPD)?

What is the efficacy of revefenacin in the treatment of chronic obstructive pulmonary disease (COPD)?

How do phosphodiesterase inhibitors work in the treatment of chronic obstructive pulmonary disease (COPD)?

How is theophylline used in the treatment of chronic obstructive pulmonary disease (COPD)?

How is roflumilast used in the treatment of chronic obstructive pulmonary disease (COPD)?

How do endogenous opioids help patients with chronic obstructive pulmonary disease (COPD)?

What is the role of beta-blockers in the treatment of patients with cardiovascular disease and chronic obstructive pulmonary disease (COPD)?

What is the role of a smoking cessation plan in the treatment of chronic obstructive pulmonary disease (COPD)?

What are the stages of smoking cessation?

What resources are available to help patients with chronic obstructive pulmonary disease (COPD) stop smoking?

What are the symptoms of nicotine withdrawal, and how can they be prevented?

What nicotine replacement therapies are available that can help patients with chronic obstructive pulmonary disease (COPD) stop smoking?

How is inflammation in chronic obstructive pulmonary disease (COPD) treated?

What is the role of inhaled corticosteroids in the treatment of inflammation in chronic obstructive pulmonary disease (COPD)?

How is the efficacy of inhaled corticosteroids on inflammation in chronic obstructive pulmonary disease (COPD) measured?

What is the role of IV steroids in the treatment of inflammation associated with chronic obstructive pulmonary disease (COPD)?

What is the role of NSAIDs in the treatment of inflammation in chronic obstructive pulmonary disease (COPD)?

What is the role of azithromycin in the treatment of chronic obstructive pulmonary disease (COPD)?

How is infection treated in chronic obstructive pulmonary disease (COPD)?

How are sputum viscosity and secretion clearance managed in chronic obstructive pulmonary disease (COPD)?

How are proton pump inhibitors (PPIs) used to treat exacerbations and the common cold in patients with chronic obstructive pulmonary disease (COPD)?

How is hypoxemia treated in chronic obstructive pulmonary disease (COPD)?

What causes carbon dioxide retention, and how can it be avoided in patients with chronic obstructive pulmonary disease (COPD)?

What are the physical hazards of oxygen therapy in chronic obstructive pulmonary disease (COPD), and how can they be avoided?

How is oxygen delivered in stable hypoxemic patients?

What is noninvasive positive-pressure ventilation (NIPPV), and how is it used in the treatment of chronic obstructive pulmonary disease (COPD)?

Which vaccinations are indicated to reduce infection in patients with chronic obstructive pulmonary disease (COPD)?

What are the treatment options for alpha1-antitrypsin (AAT) deficiency in chronic obstructive pulmonary disease (COPD)?

When is hospitalization indicated for patients with chronic obstructive pulmonary disease (COPD)?

How common are acute exacerbations of chronic obstructive pulmonary disease (AECOPD), and how are they treated?

When is assisted ventilation indicated in the treatment of chronic obstructive pulmonary disease (COPD)?

When is bullectomy indicated in the treatment of chronic obstructive pulmonary disease (COPD)?

What is the role of lung volume reduction surgery in the treatment of chronic obstructive pulmonary disease (COPD)?

What is the role of lung transplantation in the treatment of chronic obstructive pulmonary disease (COPD)?

What follow-up is indicated after an acute exacerbation of chronic obstructive pulmonary disease (AECOPD)?

What are the main goals of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD)?

How is a successful pulmonary rehabilitation program implemented in chronic obstructive pulmonary disease (COPD)?

What are the benefits of a pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD)?

What is the typical approach to a pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD)?

What is the role of patient education in a pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD)?

What is the role of exercise in a pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD)?

What is the role of breathing exercises in patients with chronic obstructive pulmonary disease (COPD)?

When is it safe for patients with chronic obstructive pulmonary disease (COPD) to fly, and what accommodations can be made when necessary?

What is the role PaO2 measurement in determining if oxygen therapy is indicated for sleep in patients with chronic obstructive pulmonary disease (COPD)?

What is the role of an end-of-life care discussion in patients with chronic obstructive pulmonary disease (COPD)?

Guidelines

What guidelines exist regarding chronic obstructive pulmonary disease (COPD)?

What are the screening guidelines for chronic obstructive pulmonary disease (COPD)?

What are the guidelines for preventing tobacco use in patients who smoke or who have chronic obstructive pulmonary disease (COPD)?

What are the GOLD guidelines for the general management of chronic obstructive pulmonary disease (COPD)?

What are the GOLD guidelines for the classification of chronic obstructive pulmonary disease (COPD)?

What are the GOLD patient group-based management recommendations for the treatment of patients with chronic obstructive pulmonary disease (COPD)?

What are the VA/DoD guidelines for the management of chronic obstructive pulmonary disease (COPD)?

What are the ACP, ACCP, ATS, and ERS joint guidelines for the diagnosis and management of stable chronic obstructive pulmonary disease (COPD)?

What are the guidelines for the use of noninvasive ventilation in patients with chronic obstructive pulmonary disease (COPD)?

What are the guidelines for the prevention of acute exacerbations in chronic obstructive pulmonary disease (COPD)?

What are the guidelines for the prevention of acute exacerbations in moderate-to-severe chronic obstructive pulmonary disease (COPD)?

What are the guidelines for the prevention of acute exacerbations in patients with any stage of chronic obstructive pulmonary disease (COPD)?

What are the guidelines for the prevention of acute exacerbations in stable chronic obstructive pulmonary disease (COPD)?

What are the guidelines for the prevention of acute exacerbations of chronic obstructive pulmonary disease (COPD) in patients aged 40 years or older who smoke or have a history of smoking?

Medications

Which types of medications are used for the treatment of chronic obstructive pulmonary disease (COPD)?

Which medications in the drug class Beta2-Adrenergic Agonists, Short-Acting are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?

Which medications in the drug class Beta2-Adrenergic Agonists, Long-Acting are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?

Which medications in the drug class Anticholinergics, Respiratory are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?

Which medications in the drug class Xanthine Derivative are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?

Which medications in the drug class Phosphodiesterase-4 Inhibitors are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?

Which medications in the drug class Corticosteroids, Inhalant are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?

Which medications in the drug class Corticosteroids, Oral are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?

Which medications in the drug class Beta-Adrenergic Agonist and Anticholinergic Agent Combinations are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?

Which medications in the drug class Beta2-Adrenergic Agonist and Corticosteroid Combinations are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?

Which medications in the drug class Antibiotics are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?

Which medications in the drug class Smoking Cessation Therapies are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?

Which medications in the drug class Other Combinations are used in the treatment of Chronic Obstructive Pulmonary Disease (COPD)?