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Respiratory System > COPD clinical features and treatment > Flashcards

COPD clinical features and treatment Flashcards

1
Q

is copd reversible

A

no

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2
Q

what effect does emphyseam have on alveoi

A

damages surface making it less able to pass air
separates alveli

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3
Q

what is the effect on broncitis

A

increased about of mucous and inflamed broncail tube wall

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4
Q

what is prevalce

A

no of peopl in population with the condition each year

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5
Q

what is incidence

A

no. of new people with the disease over a set period

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6
Q

what gender does copd mainly effect

A

males

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7
Q

what occupations are most at risk from copd

A

ariculte, brick making, mining, constuction, dock workers, flour and grain workers in the food industry, petroleum works, rubber, plastics,stone masonry

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8
Q

are larger or smaller lungs more supeiclbe to copd

A

smaller

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9
Q

what are common causes of copd

A

chroinc bronchitis, lower social eachion status, asthma, childhood infection

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10
Q

elastase

A

released by neutiophils in lungs in repsoe to chemical from cigarette smoke

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11
Q

what is teh functino of aat

A

alpha 1 antitrypisin is a protese inhibtroy proded by the liver and reduces the damage of cigarette smoke, some people can have deficies in it

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12
Q

what other disdse can a lack of aat cause

A

liver fibrois or cirrhosis

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13
Q

what percent of smokers deveolp copd during their lifetime if they smoke for more than 25 years

A

25

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14
Q

what is the fletcher peto curve

A

descibres that your fev can still stop declig at accelerated rate at any point if you stop smoking, you will never get your lost fev back

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15
Q

what are commonsymtons of copd

A

couggh, breathlessness, sputum, wheezing ( bronchoitis), frequent chest infections,

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16
Q

what are other symptons of copd

A

weight loss ( emysema) , fatique and swolen ankles (in bronchitis), use of expresity musles

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17
Q

what effect can smoking during pregnacy have on the child

A

feotal lung growth and primingy of immune system

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18
Q

what is jvp and is it seen more in

A

raised jugular pressure

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19
Q

what is teh mmrc breathlessness scale

A

puts someone on the scale of how easily they become breathlessnes, where the 0 is most people, ( strenough exercise) and the 4 is not able to leave house due to being breathlessness

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20
Q

what are the 4 level of spiromy for copd

A

1 - mild - fev` above 80%
2- moderate - fev
3 - severe - fev 30- 40
four. v. severe - fev less than 30

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21
Q

what features of a chest x ray are seen with a patient with copd

A

vascular hilda enlarged , hyper inflatoin of lungs, bulla (empysema) , small heart, flat diaphram

22
Q

do copd symptons cahnge ever

A

no generaly same throgh day and night, can be worse with flair ups

23
Q

what age is copd normaly common

A

when aged over 35 years

24
Q

what is the level of kco and dl like in copd

A

the retention of kco is reduced in copd due reduced surface area of alveoi

25
Q

what may be seen in hrct

A

in high resolution computer tomocgrutoin , may see :
lung cysts,
signets rigns signs
traction bronchiectasis
centriobular emphysesam
honey combing

26
Q

what symptons should you admit someone with copd exacerbations to hospital

A

severe breathlessnes, poor general condition, cynanois, confined to bed, oedeam worseing, imared consciousness, acute confusion, rapid rate of onset, co morbilties, sa02 less than 90

27
Q

what could cause exerbations

A

viral infections, pneothaors, trama

28
Q

what tests canbe done in hospitals for copd parties who are admitted with exacerbations

A

crx (genetic test), blood gases, fbc, uand e (urea and electrolites) , sputum culture, vts (phycological test)

29
Q

what is the treatment for copd in hospital

A

nebuliser bronchodilator (b2 and anti muscarinic), oxygen, oral /iv cortiocstiod and antibitions

30
Q

what could hand flapping when upright mean

A

reduced 02 and posible increaesd co2

31
Q

what is cor pulmonary

A

increase in size of the right side o the heart as a result of severe copd

32
Q

what is secondary polycythaemia

A

over production of erthoyctes and hameoglobing,

33
Q

what is the consequces of polycythaemia

A

increased blood viscoisty

34
Q

what are clincal feautes of cor pulmonale

A

tachycardica, oedematous, rasied jvp, congested liver, right axis devaiotn, p pulmonale, t wave inversio, pulmonary hypertension, triuspin reguritation

35
Q

what is generl criteria for bronchtis

A

chough of 3 moths or more for 2 years

36
Q

what are typical symptons of emyseam and typical symptoms of bronitoiits

A

emyseam- queiet cheest, severe dysteam, thin, flatedn diathran and hyper inflated lungs on x-ray
Bronchioitis - overweight, elevated haemoglobin, periphealed edema, wheezing

37
Q

what does pulonary hypertenio cuase

A

decreased output of left side of heart due to reduced blood flow to the area

38
Q

main non pharmolical managmets of copd

A

smoking cessation
vaccinations
pulmonary rehab
nutritional assesments
psychological support
exercise totlerece,
nutrietion

39
Q

what vaccines are best for copd

A

flu, pneuococcal

40
Q

what are saba

A

short acting beta agonists e.g. salbutamol

41
Q

what are sama

A

short acting muscalinic antagonisti (e.g. ipratroium)

42
Q

what are lama

A

long acting anti muscaling agents e.g. umeclidium and tioprium

43
Q

what are laba

A

long acting beta agonists e..g salmeterol

44
Q

what are high does corticosteriods

A

relvar e..g fluticasone and vilanterol
and fostair e..g mdi

45
Q

what is teh first steps for premodily breathlessnes

A

saba
then lama
then
lama + laba

46
Q

what are teh steps for copd with exacerbations and breathlessnes

A

saba and lama
then laba as wel
then ics on top

47
Q

what are the criteria for long term oxygne

A

long term oxygne pa02 less than 57 mm hg unlss you are polycyateic, nocutral hypotex, peripah uldema or pulpuor hypertension than it is less than 60 mm hg

48
Q

what steriods can be used for copd

A

prednisolne

49
Q

what medication is used for pallitive care

A

morphine

50
Q
A

Respiratory System (28 decks)

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