2. Chronic Obstructive Pulmonary Disease (COPD)

Question 1

What is the definition for COPD?

Answer 1

Nor exact definition for COPD, definition formed from chronic bronchitis & emphysema

Chronic bronchitis:
Presence of chronic productive cough for 3 months during 2 consecutive years

Emphysema: abnormal permanent enlargement of airspaces distal to terminal bronchiles

Question 2

How is COPD related to chronic bronchitis and emphysema?

Answer 2

Patients with COPD often have chronic bronchitis in beginning which later turns into emphysema

Question 3

What are the symptoms? (Mild disease)

Answer 3

Bronchitis:
Productive coughing, worse in the morning
Wheezing
(Shortness of breath - late sign, >60y.)

Emphysema:
Coughing with no/ small amount of sputum
Wheezing
Shortness of breath

Question 4

What are the symptoms? (Severe disease)

Answer 4

1. Tachypnea & respiratory distress with simple activities
2. central cyanosis (seen on tongue, lips)
3. elevated jugular venous pulse
4. peripheral edema

Question 5

Wh at are the findings during physical examination?

Answer 5

1. deformation of chest - hyperstenic (Barrel chest)

2. hyperresonant sound (hollow) during percussion (because more air in lungs)

Question 6

How will I diagnose COPD?

Answer 6

1. Spirometry !!!
   (If ratio is <70% : COPD)
2. X-Ray
   (Not sensitive during early stages)
3. Arterial blood gas analysis, ABG
   (Check O2 and pH: if <7,3: problem)

Question 7

What is the main cause for COPD?

Answer 7

Smoking

100% of smokers will have a stage of COPD at certain point in life

Question 8

What is the treatment for COPD?

Answer 8

1. stop smoking
2. be careful to catch infection
3. short-/ long- acting bronchodilators (depends on stage)
4. Glucocorticoids (via inhalation during first stages, in case of exacerbation intravenous)