COPD

Question 1

Which patients should be offered long term oxygen therapy in COPD?

Answer 1

ABG with p02 < 7.3 kPa
Or 
ABG with p02 7.3-8 kPa AND one of :
- secondary polycythemia 
- nocturnal hypoxaemia 
- peripheral oedema 
- pulmonary hypertension 

The ABG should be done 2 times, 3 weeks apart.

Question 2

Most common viral pathogen for exacerbations of COPD?

Answer 2

Human Rhinovirus

Question 3

When to give abx in COPD exacerbations?

Answer 3

If sputum is purulent or there are clinical signs of pneumonia

Question 4

What type of NIV do you use in COPD?

Answer 4

Bipap

Question 5

What pH level is NIV indicated in COPD?

Answer 5

pH : 7.25-7.35

If more acidotic than this HDU or intubation and ventilation might be required.

Question 6

Most useful marker of severity of COPD?

Answer 6

Fev1 (post bronchodilator)

Stage 1 :Mild >80

2: Mod 50-79
3: Severe 30-49
4: Very severe <30

Question 7

Useful investigations in a COPD work up?

Answer 7

Spiro w/ bronchodilator
CXR
FBC (for polycythemia)
BMI

Question 8

What 02 sats are you aiming for in a COPD patient with normal c02?

Answer 8

94-98%

As not a co2 retainer
Would be 88-92% if they were

Question 9

How can hypercapnia clinically present?

Answer 9

Warm and dilated peripheries, co2 flap/ asterisks, papilodema