Respiratory: COPD

Question 1

How many deaths per annum due to COPD?

Answer 1

30,000

Question 2

What does COPD increase the risk of?

Answer 2

Co-morbidities such as lung cancer and CV disease

Question 3

What are the direct and indirect costs of COPD in the UK?

Answer 3

Direct: £800m
Indirect: £24m

Question 4

What can diseases of the lungs cause?

Answer 4

Hypoxia

Question 5

What ways can diseases of the lungs cause hypoxia?

Answer 5

Airway obstruction

Impaired perfusion of the alveoli

Question 6

What is COPD?

Answer 6

All diseases where pulmonary tissue causes airflow obstruction inside the lungs

Question 7

When is diagnosis of COPD usually made?

Answer 7

In the presence of airflow obstruction in >35s who are or were previously smokers.

Question 8

What are the two main types of COPD?

Answer 8

Bronchitis

Emphysema

Question 9

What is bronchitis?

Answer 9

An inflammatory condition affecting the airways.

Question 10

What is acute bronchitis?

Answer 10

Caused by viruses or bacteria and is usually a short-lived infection.

Question 11

What is chronic bronchitis?

Answer 11

Results from long term infection and lung damage.

Question 12

Who is chronic bronchitis common in?

Answer 12

Common in the elderly

Question 13

Who is acute bronchitis common in?

Answer 13

Common in the young and elderly.

Question 14

List the signs and symptoms of bronchitis.

Answer 14

Productive cough/dispnoea
Cyanotic (blue bloaters)
Tachycardia / tachypnoea
Use of accessory muscles of respiration
Reduced SpO2 / wheezes on  auscultation 88-92
Pupils dilated / slow to react
Normal to high blood pressure
Slow Capillary refill / oedema
Reduced levels of consciousness in cases of severe hypoxia.

Question 15

What is dispnoea?

Answer 15

…

Question 16

What is cyanosis?

Answer 16

When a patients appearance is blue or purple colouration of the skin or mucous membranes due to the tissues near the skin surface having low oxygen.

Obvious sign, blue lips.

Question 17

What is oedema?

Answer 17

The puffiness around the nail bed/ankles.

Question 18

What is emphysema?

Answer 18

Distension and destruction of the alveoli and atelectasis takes place.

Question 19

What is atelectasis?

Answer 19

Lung tissue loses its elasticity and as the airways lose their muscular integrity they collapse.

Question 20

Why is the chest sometimes barrel shaped (pigeon chest) in emphysema patients?

Answer 20

Due to air being trapped in the lungs by the collapse of air passages.

Question 21

What are the signs and symptoms of emphysema?

Answer 21

Pursed lips on expiration
Barely chested / thin
Skin colour is pink (pink puffers)
Tachycardia
Tachypnoea / dyspnoea 
Use of accessory muscles of respiration and wheezing.
Percussion normally reveals a hollow sound
Confusion/anxiety/fear
Cardiac dysrhythmias
Elevated B.P
Evidence of Oedema

Question 22

What are the features of acute exacerbation of COPD?

Answer 22

Increased dyspnoea 
Increased sputum 
Increased cough
Upper airway symptoms (cold, sore throat etc)
Increased wheeze
Chest tightness
Reduced exercise tolerance
Fluid retention
Increased fatigue
Acute confusion
Worsening of previous stable condition.

Pg 137 jar calc

Question 23

What are the features of sever exacerbation of COPD?

Answer 23

Marked dyspnoea 
Tachypnoea
Purse lip breathing
Use of accessory muscles at rest
Acute confusion
New onset peripheral oedema
Marked reduction in daily living

Question 24

Name some conditions with similar features to acute COPD.

Answer 24

Asthma
Pneumonia
Pneumothorax
LVF/pulmonary oedema
Pulmonary embolus
Lung cancer
Upper airway obstruction
Pleural effusion
Recurrent aspiration

Question 25

List management of COPD

Answer 25

Individual treatment plan?
Diagnosis?
Airway?
Breathing?
Bronchodilators
Position
Oxygen
ECG
ventilation
Cardio-respiratory arrest
Transfer

Question 26

What does COPD stand for?

Answer 26

Chronic Obstructive Pulmonary Disease