Lecture 20

Question 1

What is COPD?

Answer 1

• COPD is a disease that is characterised by limited airflow that is not fully reversible
• Airflow limitation is usually progressive and there is usually an abnormal inflammatory response to noxious chemicals
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Question 2

What is the common history for a patient with COPD?

Answer 2

• Producitive cough
• Dypnea
• Cigarette smoking

Question 3

What does the spirometry of a pateint with COPD look like?

Answer 3

• Reduced FEV1
• FEV1/FVC < 70%

Question 4

What are the differences between COPD and asthma?

Answer 4

• COPD irreverible, late onset, progresive

Question 5

What are the risk factors for COPD?

Answer 5

• Smoking
• Occupational dusts, organic and inorganic
• Indoor air pollution from heating and cooking with biomass in poorly ventilated dwellings
• Outdoor air pollution
• Genes
• Lung growth and development
• Oxidative stress
• Gender
• Age
• Respiratory infections
• Socioeconomic status
• Nutrition
• Co-morbidities

Question 6

What are the degrees of severity of COPD?

Answer 6

• post b/dilator FEV1%

Question 7

Suggested treatments for differing severities of COPD?

Answer 7

Question 8

What are the steps in diagnosis and management of COPD?

Answer 8

• COPD-x:
  
  • Confirm diagnosis
  • Optimise management
  • Prevent deterioration
  • Develop self management plan
  • Manage eXacerbations

Question 9

How is deterioration prevented?

Answer 9

• Essential steps:
  
  • influezna A vaccination annually
  • Pneumococcal vaccination (Level B) (re-vaccination 5 & 10 yrs)
  • Consider long-term home oxygen
• Avoid risk factors e.g smoking

Question 10

What is respiratory rehabilitation?

Answer 10

• Pulmonary rehabilitation reduces carer strain and increases patient knowledge
• Reduces dyspnoea, anxiety and depression, improves exercise capacity QOL and may reduce hospital admissions
• Multi disciplinary care plans and individual self-management plans may help prevent or manage crises
• Advanced care planning – end-of-life discussions - Concerto

Question 11

What is advanced care planning?

Answer 11

• ACP is a process of thinking about, talking about and planning for future health care and end-of-life
• ACP gives people the opportunity to develop & express their preferences for future care based on:
  
  • their values, beliefs, concerns, hopes & goals
  • a better understanding of their current & likely future health
  • the treatment & care options available