COPD Flashcards
What is COPD?
Chronic obstruction of lung airflow
What are the 2 parts of COPD?
Chronic bronchitis- clinical diagnosis. Blue bloaters.
Emphysema- pathological diagnosis. Pink puffers
What is chronic bronchitis?
Cough productive of sputum most days in 3 consecutive months for 2+ years
What is the pathology of chronic bronchitis?
Exposure to irritants causes mucus gland and goblet cell hyperplasia
Increase in mucus causes airway obstruction
Immobile cilia can’t clear mucus plugs
What is emphysema?
Destruction of alveolar walls causing loss of elastcity and surface area
What are the morphological types of emphysema?
Centriacinar- proximal alveoli
Panacinar- entire acinus
Para septal- distal alveoli
What is an acinus?
Portion of the lungs distal to a terminal bronchiole and supplied by a respiratory bronchiole
What is a bulla?
Emphysematous space> 1cm
What are the causes of COPD?
Smoking
Occupation
Air pollution
Age
Asthma
Alpha-1 antitrypsin deficiency
What is alpha-1 antitrypsin deficiency?
AAT is a protease inhibitor that limits alveolar damage
When absent it leads to emphysema
What are the symptoms of COPD?
Cough
SoB
Sputum
Recurring chest infections
Wheezing
Weight loss
Fatigue
Swollen ankles
Tripod position
What are the signs of COPD?
Pursed lip breathing
Hyperinflated chest
Cyanosis
Wheeze
Use of accessory muscles
Peripheral oedema
Cachexia
Raised JVP
What are the investigations for COPD?
Spirometry
CT scan
CXR
FBC
Sputum sample
What will spirometry show?
Reduced FEV1: FVC ratio
Mild- 80%
Moderate- 50-79%
Severe- 30- 49%
Very severe- <30%
What are the types of respiratory failure?
- Low PO2
- Low PO2, High PCO2
