Clinical features of COPD Flashcards

(38 cards)

1
Q

WHO definition of COPD

A

a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible (hence chronic)

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2
Q

what does COPD stand for?

A

Chronic obstructive pulmonary disease

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3
Q

how do you distinguish between asthma and COPD?

A

asthma is reversible where as COPD isn’t

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4
Q

what is the biggest COPD risk factor in high and middle income countries?

A

tobacco smoke

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5
Q

what is the biggest COPD risk factor in low- income countries

A

exposure to indoor air pollution such as the use of biomass fuels for cooking and heating

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6
Q

what are some occupational exposures that can cause COPD?

A

exposure to dusts, vapours or fumes

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7
Q

in the UK what is the biggest cause of COPD

A

smoking

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8
Q

TRUE or FALSE. Any factor that affects lung growth during gestation and childhood has the potential for increasing an individual’s risk of developing COPD

A

TRUE

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9
Q

FEV1 progression over time difference between people with NO COPD and those with COPD?

A

those without COPD have higher FEV1 results even into old age than those with COPD

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10
Q

which gender are more likely to get COPD?

A

females

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11
Q

what is one of the main causes to look out for in people that present with COPD at a young age

A

Alpha-1 antitrypsin deficiency.

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12
Q

which 3 health conditions is COPD related with?

A

asthma
chronic bronchitis
emphysema

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13
Q

what are the aetiologies of COPD

A

smoking and pollutants and host factors

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14
Q

whats the pathobiology of COPD

A

impaired lung growth accelerated decline lung injury lung systemic inflammation

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15
Q

what is Alpha-1 antitrypsin (AAT) and why is a lack of them a cause of COPD

A

It clears up proteases.

When you get an infection or inhale tobacco smoke etc neutrophils release proteases.
Normally antitrypsin would come and clear up these proteases however some people have a genetic disorder that means they don’t produce anti-trypsin or enough of it

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16
Q

what’s the pathology of COPD?

A

small airway
disorders or abnormalities emphysema
systemic effects

17
Q

what is FEV1

A

Forced expiratory volume in one second

- It shows the amount of air a person can forcefully exhale in one second of the FVC test.

18
Q

Initial presentation of COPD (5)

A

it’s varied but there are some ‘typical’ symptoms

shortness of breath
recurrent chest infections
ongoing cough (not clearing up)
wheeze 
productive cough / sputum
19
Q

what are other less common symptoms associated with COPD? (4)

A

weight loss (calorie consumption)
fatigue
decreased exercise tolerance
ankle swelling (if it is causing heart failure)

20
Q

how do you diagnose COPD?

A

there is no single diagnostic test

you have to take a history and carry out spirometry test

21
Q

you can make a diagnosis of COPD if a person meets what criteria? (5)

A

over 35
has risk factors
shows typical symptoms
shows absence of clinical features of asthma
AND
has airflow obstruction confirmed by post-bronchodilator spirometry

22
Q

what is spirometry?

A

test used to help diagnose and monitor certain lung conditions/ lung function

Do this by measuring how much air you can breathe out in one forced breath ie one second (FEV1) and then carry on breathing out for the FVC which is forced vital capacity (total amount of air you can exhale after full inhalation)

ratio norm value 80%

23
Q

What happens to FEV1 and FVC in an obstructive disorder (hard to exhale)?

A

FEV1 is reduced
FVC is usually reduced but to a lesser extent than FEV1
ratio is reduced

24
Q

what is FVC?

A

the total amount of air that can be forcibly exhaled from the lungs after taking a full inhalation

25
what is the predicted normal FVC and FEV1 value and ratio?
<80% | ratio <0.7
26
What happens to FEV1 and FVC in an restrictive disorder (harder to expand lungs)?
FEV1 is reduced FVC is reduced but ratio is normal
27
what is an x-ray used for in clinical setting for COPD
to exclude other pathology | it is not part of diagnostic
28
what are signs of hyperinflation of the lungs on an x-ray?
bulla - large areas of dead space small heart more than 6 anterior ribs or 10 posterior showing - diapraghm moves down so can see ribs due to air in lungs
29
what questions would you ask someone in clinical setting to work out if it was COPD or not?
Worse at night? How much sputum? Variation? Response to steroids? Triggers? (exercise)
30
people with COPD have increased ____volume?
residual ie more air left over in lungs because can't exhale much air
31
difference in onset of COPD and asthma
onset of COPD is usually midlife/ older | onset of asthma is usually early childhood
32
how do you manage COPD
``` Change in inhalers (technique, device, add bronchodilator, increase or add inhaled steroid) Oral steroids (Prednisolone tablets) Antibiotics ```
33
what is cyanosis
a severe exacerbation involved with COPD that causes your skin to appear blue due to lack of O2
34
what is cor pulmonale?
lung failure due to heart failure
35
differences between chronic bronchitis and emphysema patients
chronic bronchitis - overweight and cyanotic, elevated haemoglobin, peripheral oedema, ronchi and wheezing Emphysema- older and thin person, severe dyspnea (SOB), quiet chest, x-ray, hyperinflation with flattened diaphragms
36
co-morbidities often found along side COPD
heart disease, cerebrovascular and peripheral vascular disease
37
what are ronchi?
continuous low pitched, rattling lung sounds that often resemble snoring.
38
TRUE OR FALSE | COPD is the second largest cause of emergency admissions in the UK
TRUE