COPD

Question 1

what does it stand for?

Answer 1

chronic obstructive pulmonary disorder

Question 2

how many in uk affected?

Answer 2

1.2 million and its increasing

Question 3

obstructive or restrictive

Answer 3

obstructive

Question 4

can it be reversed?

Answer 4

little to none

Question 5

fev1/fvc ratio

Answer 5

<0.7

Question 6

two things which define copd

Answer 6

chronic bronchitis

emphysema

Question 7

favoured onset

who mostly affected

Answer 7

over 35 years of age
most common in men
increasing in women
smokers

Question 8

define chronic bronchitis

Answer 8

on most days of 3 months of 2 successive years of coughing and sputum

Question 9

improvement seen with?

Answer 9

smoking cessation

Question 10

symptoms

Answer 10

sputum 
chronic cough
dyspnoea -noturnal
SOB
wheeze

Question 11

signs

Answer 11

hyper-resonant chest 
hyperinflated chest (seen on XRAY too)
tachypnoea 
USE OF ACCESSORY MUSCLES for respiration
cyanosis
crackles on auscultation
orthopnoea -sob when lying flat

Question 12

diagnosis

Answer 12

PEF, spirometry
bloods- fbc
oxygen sats
xray to exclude differentials

Question 13

differentials of copd

Answer 13

asthma
bronchitis
alpha 1 anti trypsin defieicncy 
emphysema
PE
CHF

Question 14

what is xray used for?

Answer 14

to exclude a PE and CHF

Question 15

what are complications?

Answer 15

infection
resp failure 
cor pulmonale
polycythaemia 
lung carincokma

Question 16

1st line advice

Answer 16

quit smoking

Question 17

first line medication?

Answer 17

short acting bronchodilators

Question 18

then?

Answer 18

inhaled corticosteroids and LA brochodilators

Question 19

another one which is used in severe copd

Answer 19

theophylline

Question 20

name 3 short acting

Answer 20

salbutamol
ipratropium
tiotropium

Question 21

name a come combination one and what is it made of and their moa

Answer 21

symbicort- formoetrol (reduces inflamm) and budesonide (bronchodilator)

Question 22

two later options for treatment?

Answer 22

oxygen

surgery /transplant (rarer)

Question 23

what are the key differences between type a and type b?

Answer 23

type a - pink puffer

type b - blue bloater

Question 24

describe pink puffer?

Answer 24

normal/low o2, normal low co2
increased alveolar ventilation
resp type 1 failure
breathless but not cyanosed

Question 25

describe blue bloaters

Answer 25

decreased alveolar ventilation
core pulomonale
cyanoised
resp type 2 failure

Question 26

what does BB rely on? why is this significant?

Answer 26

hypoxic drive

therefore o2 given with care

Question 27

why does o2 have to be given wth care?

Answer 27

[1] low oxygen levels as the main stimulus of respiration (hypoxic drive).

[2] giving supplemental oxygen reduces their stimulus to breathe as oxygen is given

[3] causes respiration to slow (hypoventilation)

[4] this allows carbon dioxide to accumulate in the body.