COPD Flashcards
normal FEV1/FVC ratio
- 70%
what conditions are included in COPD
- chronic bronchitis
- emphysema
where in the US do we see higher incidence of COPD
what is it correlated with
- tobacco belt
- lower SES classes
risk factors for COPD
- cigarette smoking
- passive smoking
- biomass fuels
- hyper-responsive airways
- occupational factors
genetic cause of emphysema
- alpha1 antitrypsin deficiency
pathogenesis of emphysema
- elastase (degrades elastin) and alpha-1 antitrypsin inactivation
- involves innate and adaptive immunity
vicious circle hypothesis
- initiating factors (smoking or childhood disease) + genetic predisposition
result of pathogenesis of COPD
- small airway remodeling (fibrosis)
- alveolar wall destruction (emphysema)
- mucus hypersecretion
mechanisms of physiologic obstruction
- filling of lumen with mucus in chronic bronchitis
- wall thickening/airway fibrosis in chronic bronchitis
- loss of tethering in emphysema
emphysema leads to loss of _________ and results in _________
- loss of elastic recoil
- results in airway collapse
symptoms of COPD
- shortness of breath
- cough
- wheezing
- fatigue
- weakenss
symptoms of COPD late in illness
- morning headaches
- lower leg swelling due to cor pulmonale
signs of COPD
- barrel chest
- accessory muscles
- wheezing
- tripod
- decreased breath sounds
- lower extremity edema
spirometry of COPD
- reduced FEV1/FVC ratio below 70%
FEV1/FVC lower limits of normal declines with
- age
FRC in emphysema
- increased FRC
RV in emphysema
- increased RV
TLC in emphysema
- increased TLC
chest x ray features in COPD
- low, flattened diaphragm
- air trapping
- increased A-P diameter
effect of exercise on hyperinflation
- gas trapping will get worse when you exercise
- inspiratory capacity will get smaller
symptoms with COPD correlate with
- inspiratory capacity
classic ABG levels for COPD
- 60 pCO2
- 60 pO2
V/Q of COPD
- V/Q mismatching
complication of chronic hypoxemia associated with COPD
- cor pulmonale
