COPD Flashcards
(35 cards)
What are the general risk factors for developing COPD?
Smoking, Chemicals, Environmental, Genetics, Alpha anti-trypsin
What are the risk factors for developing COPD specific to the case study?
Major one is Smoking (~10 a day for about 40 years not anymore). Environmental worked in social wellfare and had ‘muck’ dropping on her. Genetic mother, brother and sister all died from COPD.
What are the general signs and symptoms of COPD?
Barrel chest, blue tinged lips, chronic cough, finger clubbing, pursed lips when breathing, shortness of breath on exertion, use of accessory muscles when breathing, laboured breathing
What are the signs and symptoms of COPD specific to the case study?
Breathlessness/SOB with exertion, Dyspnoea/laboured breathing, Pursed lip breathing, Barrel shaped chest, increased expiratory effort, use of accessory muscles, slightly bluish/purple tinged lips.
What is the general pathophysiology of COPD.
Chronic inflammation in alveoli
- Increased oxidative stress
and
- Increased proteases
Leading to:
Tissue breakdown
- Alveolar walls
- Pulmonary capillary walls
- Elastic fibres
What are the complications that arise from COPD specific to the case study?
Decreased appetite therefore weightloss (2kg) emaciation. Occasionally she gets ankle swelling/oedema secondary to right sided heart condition which is a complication of her COPD. Cyanosis (purple/blue tinged lips). Episodes of acute respiratory failure.
What is Emphysema?
- loss/destruction of alveoli & associated capillaries
- Loss of elastin
- Enlarged air spaces & air trapping
- Decreased surface area of alveoli => decreased gas exchange
What is Bronchitis COPD?
- Bronchial inflammation & oedema
- Increased mucous production
- Decreased cilia action
- Increased airway resistance => decreased gas exchange
What can enlarged airspaces lead to?
> Air retention
Hyperinflation
-> affects on thoracic cavity
-> Changes in lung volume (^ residual volume)
=> Increased work of breathing
What can reduced alveolar surface area lead to?
- Decreased gas exchange
- Hypoxia (Decreased O2 in tissue) - Hypercapnia (Increased CO2)
- Acidosis, Pulmonary hypertension
- Respiratory failure
What type of COPD does the case study patient have?
Emphysema and Chronic bronchitis
Other Complications of COPD.
Respiratory Acidosis
Metabolic Acidosis
Cyanosis
Tissue wasting/emaciation
Pulmonary hypertension & cor pulmonale
Respiratory failure
What are the 2 expected lab tests for COPD on admission?
Blood gases and pH
Sputum Sample
What are the expected investigations for COPD on admission?
Chest x-ray
Pulmonary function tests
ECG
What is the purpose of the arterial blood gas test?
Checks oxygenation status and acid balance
What is the purpose of the pulse oximetry test?
Estimates O2 content in arterial blood using light
What is the purpose of the Peak expiratory flow (PEF) test?
Measures how quickly you can exhale.
What is the purpose of the body plethysmography test?
Measures thoracic volume and airway resistance.
What is the purpose of the forced expiratory volume (FEV) test?
Tests how much air you can exhale in 1 second.
What is the purpose of the diffusing capicity test?
Tests oxygen transfer from the alveoli to circulation.
What is the purpose of the sputum culture test?
Used to diagnose bacterial lung infection.
What is often revealed in a COPD patients blood tests?
Increased hemoglobin level with an increased red blood cell count and a raised hematocrit.
What does raised hemoglobin level with increased red blood cell count and a raised hematocrit indicate the body is doing?
compensating for lower PO2 by increasing the O2 carrying capacity of the blood
What does raised PCO2 result in?
Chronic respiratory acidosis
