Clinical features of COPD 2 Flashcards
(30 cards)
After 25 years of smoking, how many smokers without initial disease will have significant COPD (stage 2 or worse) and how many will have any COPD?
25% will have stage 2 or worse COPD30
40% will have any form of COPD
How can smoking cause COPD in people who do not smoke?
Environmental tobacco causes COPD (second hand smoke)
What does smoking during pregnancy affect?
Foetal lung growth and priming of the immune system.
What curve is this?
Fletcher-peto curve
What level of FEV1 do clinical symptoms occur at?
About 50%
What is important to know about the initial presentation of COPD?
Initial presentation is varied
What are some typical symptoms of COPD?
Shortness of breath
Recurrent chest infections
Ongoing cough, not clearing up
Wheeze
Productive cough/sputum
What are some less common symptoms of COPD?
Weight loss
Fatigue
Decreased exercise tolerance
Ankle swelling
What are some clinical features of COPD on examination?
Cyanosis
Raised jugular venous pressure (JVP)
Cachexia
Hyperinflated chest
Pursed lip breathing
Use of accessory muscles
Wheeze
Peripheral oedema
Acute exacerbations
What do the clinical features on examination depend on?
Severity
What is cachexia?
Weakness and wasting of the body due to severe chronic illness
What is peripheral oedema?
Fluid collecting in cavities or tissues in the body
What can you say about a single diagnostic test for COPD?
No such thing exists
What should the criteria of someone be to make a COPD diagnosis?
> 35 years old
Presence of risk factor
Presence of typical symptoms
Absence of clinical features of asthma
Airflow obstruction confirmed by post-bronchodilator spirometry
When does spirometry suggest COPD?
FEV/FVC <0.7 post bronchodilator suggests lack of reversibility which is COPD
What is stage 1 COPD?
Mild, FEV1 more than 80% of predicted value
What is stage 2 COPD?
Moderate, FEV1 50-79% of predicted value
What is stage 3 COPD?
Severe, FEV1 30-49% of predicted value
What is stage 4 COPD?
Very severe, FEV1 less than 30% of predicted value
What is end stage COPD?
Not part of the staging classification but is often used in practice
What are the 2 kinds of spirometry patterns (diseased)
Obstructive and Restrictive
When is spirometry pattern obstructive?
FEV1 reduced
FVC reduced to a lesser extent
FEV1/FVC ratio reduced (<0.7)
When is a spirometry pattern restrictive?
FEV1 reduced
FVC reduced
FEV1/FVC ratio normal (>0.7)
Which is obstructive and which is restrictive?
A is obstructive
B is restrictive
