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Respiratory System > COPD > Flashcards

COPD Flashcards

1
Q

What is COPD?

A
  • a disease characterised by persistent expiration symptoms + airflow limitation
  • due to airways and/or alveolar abnormalities
  • caused by significant exposure to noxious particles or gas
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2
Q

What is COPD caused by?

A

Significant exposure to noxious particles or gases

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3
Q

Symptoms of COPD

A

Shortness of breath
Chronic productive cough
Chronic sputum production
Recurrrent lower respiratory tract infections

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4
Q

Risk factors for COPD

A

Host factors e.g. genetics, congenital abnormalities | alpha 1 anti trypsin deficiency
Tobacco
Occupation
Indoor/outdoor pollution
Illicit drug use e.g. heroin

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5
Q

What causes airflow limitation in COPD?

A
  • Small airways disease: airway inflammation, airway fibrosis > increased airway resistance (+ loss of radial traction)
  • Parenchymal destruction: loss of alveolar attachments > decrease of elastic recoil
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6
Q

Signs of COPD

A
  • purse lip breathing
  • prolonged expiratory phase
  • hyperinflation or barrel shaped chest
  • visible use of accessory muscle
  • Tachypnoea
  • wheeze on auscultation
  • rales (crackles)
  • hypoxemia + hypercapnia
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7
Q

What is needed to diagnose COPD?

A

Spirometry test

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8
Q

What is emphysema?

A
  • condition in which destruction of the terminal bronchioles + distal air spaces occurs via the breakdown of elastin
  • permanent enlargement of air spaces (bullae)
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9
Q

What two main conditions is COPD used to describe?

A

Emphysema: damaged air sacs
Chronic bronchitis: inflammation + productive cough

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10
Q

What is chronic bronchitis?

A
  • condition where there is hypersecretion of mucus due to inflammation of large airways
  • ciliary dysfunction > issue with clearance
  • productive cough
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11
Q

What is used to grade dyspnoea?

A

MRC dyspnoea score

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12
Q

Signs of late COPD

A
  • flapping tremor (hypercapnia)
  • central cyanosis (hypoxia)
  • right sided heart failure signs e.g. distended neck veins, ankle oedema
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13
Q

What is exacerbation of COPD?

A

Acute worsening of respiratory symptoms that result in addition therapy
At least one major symptom:
- dyspnoea
- sputum volume
- sputum purulence

And one minor symptom:
- wheezing
- cough
- fever

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14
Q

Common bacteria that cause COPD

A
  • Haemophilus influenzae
  • Streptococcus pneumoniae
  • Haemophilus parainfluenzae
  • Moraxella catarrhalis
    • how many need to know?
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15
Q

Common viruses that cause COPD

A
  • rhinoviruses
  • coronavirus
  • influenza
  • parainfluenza
  • adenovirus
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16
Q

What therapies improve the symptoms of COPD?o

A
  • pulmonary rehabilitation
  • bronchodilators
  • lung transplant
  • lung volume reduction surgery
  • mucolytics
17
Q

What therapies improves the risk of COPD?

A
  • stop smoking
  • oxygen therapy
  • anti inflammatories
  • non-invasive ventilation
  • flu vaccine
18
Q

What bronchodilators are used for COPD treatment?

A

Beta antagonists
Anti muscarinics

19
Q

When is ambulatory oxygen given?

A

If patient desaturates when they walk (>4%)

20
Q

Why is long term oxygen therapy used?

A

To protect organs when hypoxic

21
Q

What is chronic bronchitis defined by?

A

Clinical features
Specifically a productive cough

22
Q

What is emphysema defined by?

A

Structural changes
(Enlarged air apices)

23
Q

What is the main risk factor of COPD?

A

Smoking

24
Q

How do you classify the severity of airflow obstruction in COPD?

A

FEV1 / FVC ratio
Forced expiratory volume in 1 second
Forced vital capacity

25
Q

What epithelial cells line the airways?

A

Ciliated pseudostratified columnar
Goblet cells

26
Q

How does exposure to triggers cause COPD?

A

Hypertrophy + hyperplasia of:
- bronchial mucinous glands (main bronchi)
- goblet cells (bronchioles)
Production of mucous > obstruction of airways

Smoking also shortens cilia > harder to move mucous

27
Q

FEV1 and FVC in patient with COPD

A

FEV1 - very low
FVC - low

28
Q

How can COPD cause cor pulmonae (right sided heart failure)

A
  • vasoconstriction to a large proportion of lungs
  • increased pulmonary vascular resistance
  • pulmonary hypertension
  • more work for right side of heart
  • right sided heart failure
29
Q

How can alpha-1 antitrypsin deficiency causes COPD?

A
  • alpha-1 antitrypsin is a antiproteinase
  • the deficiency leads to an imbalance in proteinases + antiproteinases
  • this leads to destruction of alveolar walls + emphysema
30
Q

Typical colour of purulent sputum

A

Yellow or green

31
Q

Complications of COPD

A
  • cor pulmonale
  • respiratory failure
  • pneumothorax
  • recurrent pneumonia
32
Q

How can you differentiate between asthma and COPD using spirometry?

A
  • asthma is reversible so if you give bronchodilators the FEV1:FVC will increase (by at least 12%)
  • COPD is irreversible so bronchodilators wont increase ratio
33
Q

How much must the FEV1:FVC increase after the use of bronchodilators for the condition to be deemed reversible (asthma)?

A

At least 12%

34
Q

FEV1:FVC ratio in obstructive conditions

A

<70%

Respiratory System (20 decks)

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