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Flashcards in 15 COPD Deck (15)
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1

What is COPD?

Chronic obstructive pulmonary disease

Not fully reversible, progressive

  • Emphysema
  • Chronic bronchitis 

Inflammatory response to noxious particles or gases- primarily cigarette smoke

 

2

Apart from cigarette smoke (90% cases) , what are some other causes of COPD?

  • Air pollution (developing countries)
  • Occupational exposure
  • Alpha-1 antitrypsin deficiency
    • (alpha-1 antitrypsin= antiproteinase so destruction of alveolar walls) 
  • Not reaching full lung capacity in childhood?

3

Outline the pathophysiology of COPD

4

How do the changes that occur as a result of COPD lead to increased airway resistance?

5

What complications can be caused by COPD?

  • Cor pulmonae (right side hear failure)
    • Progressive hypoxia
      • Pulmonary vasoconstriction due to V/Q imbalance​
        • Pulmonary hypertension
          • ​Vascular smooth muscle thickening
            • Oedema
  • Recurrent pneumonia
  • Respiratory failure
  • Pneumothorax: lung tissue damage- rupture 

6

The initial symptom of COPD is a cough. Describe the cough.

Frequently - morning cough 

..then constant cough as disease progresses

Productive

7

Apart from a cough, how else will a patient with COPD present?

History?

Older person, History of smoking

Initial symtoms?

Shortness of breath

Productive cough

Physical examination? 

Tachypnoea

Accessory muscle use  (SCM, pectoralis major and minor, serratus anterior, latissimus dorsi, and serratus posterior superior)

Barrel chest

Hyper-resonance on percussion

Reduced intensity (distance breath sounds) 

Wheezing

Late features?

Central cyanosis

Flapping tremors (CO2 retention)

Right sided heart failure ( distended neck veins, hepatomegaly, ankle oedema) 

 

 

8

What investigations should be carried out for suspected COPD?

9

How is COPD treated?

Conservative

Stop smoking

Pneumococcal vaccination

Monitor patient: weight, nutrition status, physical activity

Pulmonary rehabilitation

Strengthen muscles, disease education, nutritional advice

 

Pharmacological

Bronchodilators

Inhaled corticosteroids

Long-term oxygen treatment 

 

Surgical

Removal of large bullae (fluid filled sac) 

Lung volume reduction

Lung transplant

 

 

10

What is an acute exacerbation of COPD? How will it present?

Event characterised by change in patients baseline dyspnoea/ cough/sputum beyound normal day to day variations and acute onset

PRESENTATION

- acute, severe shortness of breath

- fever

-chest pain

 

11

How are acute exacerbations of COPD managed?

12

How does someones FEV1 change with age? 

13

A patient presents with dyspnea. How can we quantify this? 

14

What are the risk factors for acute exacerbations of COPD?

15

If a patient is admitted to hospital with an acute exacerbation of COPD, what is there chance of being readmitted within 3 months? 

43% in 3 months