COPD

Question 1

Epidemiology of COPD

Answer 1

COPD is underdiagnosed. 60-85% of patients, mainly with mild-to-moderate disease, are thought to remain undiagnosed.
3 million people died globally a year 6% of all deaths globally.
Closely associated with levels of deprivation - rates of COPD are higher in more deprived communities
M=W

Question 2

aetiology of COPD

Answer 2

more than smokers lung
air polution
genetics

Question 3

natural history of COPD

Answer 3

lung function decline - respiratory failure death

Question 4

Symptoms of COPD

Answer 4

coughing
worsening dyspnoea
increasing exercise intolerance
sputum production

Question 5

Signs

Answer 5

Respiratory distress: tachypnoea, breathlessness on exertion, increased use of accessory muscles of respiration, pursed lip breathing.
Abnormal posture: patients may lean forward and rest their arms on the table to ease breathing.
Drowsiness, flapping tremor and mental confusion (from cyanosis)
Other signs include being underweight, ankle oedema, hyperinflation of the chest, downward displacement of the liver, relatively quiet vesicular breath sounds, wheezing, prolonged forced expiratory time

Question 6

Complications

Answer 6

weight loss 
pnuemothorax
respiratory infection
pulmonary hypertenstion R heart failure/cor pormonale
accute/chronic respiratory failure

Question 7

Prognosis

Answer 7

progressive, 50% of sever = death in 10 yrs, symptoms treatable but not curable.

Question 8

Pathophysiology of COPD

Answer 8

inflammation due to smoke or other irritant
not fully reversible
The airflow obstruction is due to a combination of airway and parenchymal damage
and inflammation/mucus
loss of recoil
often infection