clinical features of COPD Flashcards
whats the definition of COPD
Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases.
what 3 things is COPD associated with?
chronic bronchitis
emphysema
asthma
whats the etiology of COPD
smoking and pollutants and host factors
whats the patholobiology of COPD
impaired lung growth
accelerated decline
lung injury
lung and systemic inflammation
whats the pathology of COPD
small airway disorders of abnormalities
emphysema
systemic effects
what is FEV1
Forced expiratory volume is measured during the forced vital capacity test. The forced expiratory volume in one second (FEV1) measurement shows the amount of air a person can forcefully exhale in one second of the FVC test.
what is alpha 1 antitrypsin deficiency?
Rare, inherited disease, presents with early onset COPD <45yrs
Alpha-1 antitrypsin (AAT) is a protease inhibitor made in the liver
Limits damage caused by activated neutrophils releasing elastase in response to infection/cigarette smoke
what are the initial presentation of symptoms for COPD
Varied!
Some “typical” symptoms Shortness of breath Recurrent chest infections Ongoing cough, “not clearing up” Wheeze Productive cough / sputum
what are other symptoms that are less common?
Weight loss (calorie consumption)
Fatigue
Decreased exercise tolerance
Ankle swelling (if causing heart failure)
Cor Pulmonale
what are the investigations and diagnosis for people with COPD?
No single diagnostic test – History & Spirometry
Make a diagnosis of COPD if a person meets all of the following criteria:
◦>35 years old
◦Presence of risk factor (smoking or occupational exposure)
◦Presence of typical symptoms
◦Absence of clinical features of asthma
AND
Airflow obstruction confirmed by post-bronchodilator spirometry
whats the prevalence of COPD
1.2 million living with a diagnosis of COPD = 2% population
2nd most common lung disease after asthma
At least 50% undiagnosed i.e. 3m
Prevalence is increasing
what does the FEV1 have to be for it to be COPD?
<0.7
what is Hyperinflation
More than 6 anterior or 10 posterior ribs in the mid-clavicular line at thelungdiaphragm level.
if someone comes in with a cough what would you ask them to determine if it is COPD
Worse at night? How much sputum? Variation? Response to steroids? Triggers? (exercise)
when are you likely to get COPD compared to asthma?
copd- onset in mmidlife
asthma - onset early life, often childhood
