copd Flashcards
features COPD
cough // SOB // wheeze // smoking // severe = right HF
bronchitis and emphysema COPD
bronchitis = -Smooth muscle spasm and hypertrophy // emphysema = alveolar destruction –> decreased air exchange
CXR COPD
hyperinflated // bullae (mimic pneumothorax)
why is FBC required for COPD
secondary polycythaemia
diagnosis COPD
spirometry - FEV1/FVC <0.7 // FEV1 reduced, FVC normal
stage 1 COPD spirometry
FEV1 >80% + symptomatic
stage 2 COPD spirometry
FEV 50-79%
stage 3 COPD spirometry
FEV1 40-49 % (severe)
stage 4 COPD spirometry
FEV1 <30% (V severe)
general mx COPD
smoking cessation // influenza vaccine // one off pneumococcal vaccine // pulm rehab
COPD 1st line mx
1 = SABA OR SAMA
COPD progressive mx no features asthma
1 = SABA or SAMA // 2 = SABA + LABA + LAMA // 3 = theophylline
what featured indicate asthma COPD overlap
history atopy // high eosinophils // variation in FEV1 (esp diurnal)
COPD progressive mx with features asthma
1 = SAMA OR SAMA // 2 = add LABA + ICS // 3 = SABA + LAMA + LABA + ICS (no LAMA) // 4 = add theophylline
important note with LAMA + SAMA
cannot be taken together, if adding LAMA discontinue SAMA
interaction theophylline with abx
reduce macrolide (eyrthromycin, clarithromycin) + fluroquinilones (ciprofloxacin)
abx prophylaxis in COPD
azithromycin
monitoring with azithromycin
ECG (azithromycin prolongs QT interval)
features cor pulmonale COPD
peripheral oedema, raised JVP, parasternal heave
mx cor pulmonale COPD
diuretics + long term O2
methods to improve surviva COPD
stop smoking // long term O2 // long volume surgery
who should be assessed for long term O2 COPD
FEV1 <30% // cyanosis // polycythaemia // peripheral oedema // raised JVP // O2 <92%
how is long term O2 COPD assessment done + what results indicate need for it
2 ABG 3 weeks apart // pO2 <7.3 // OR pO2 between 7.3-7.8 + one of: polycythaemia, peripheral oedema, pulm HTN
who is not suitable for long term O2 COPD
smokers!!
