COPD Flashcards Preview

ESA 3 - Respiratory System > COPD > Flashcards

Flashcards in COPD Deck (44):
1

What is Chronic Obstructive Pulmonary Disease (COPD)?

A chronic, slowly progressive disease disorder characterised by airflow obstruction, which does not charge markedly over several months 

2

What is the effect of airflow obstruction on FEV1?

  • Reduced FEV1
  • Reduced FEV1/FVC ratio

 

3

What causes COPD?

The abnormal inflammatory response of the lung to noxious particles or gases

4

Where can noxious particles or gases come from?

  • Cigarette smoke
  • Atmospheric pollutants

 

5

What components of cigarette smoke cause lung inflammation? 

  • Biomass particles 
  • Particulates 

 

6

What can make the inflammation caused by cigarette smoke worse?

  • Host factors 
  • Amplifying mechanisms

 

7

How does lung inflammation from cigarette smoke cause COPD?

  • Directly
  • Oxidative stress
  • Proteinases 

 

8

What attempts to protect against oxidative stress? 

Anti-oxidants 

9

What attempts to protect against the action of proteinases? 

  • Anti-proteinases 
  • Repair mechanisms

 

10

What is a much less common cause of emphysema?

Inherited deficiency of α1-antitrypsin 

11

What are the symptoms of COPD? 

  • Productive cough
  • Wheeze
  • Breathlessness

 

12

What does the productive cough in COPD produce? 

White or clear sputum

13

What does COPD usually follow?

Many years of smokers cough

14

What are the signs of COPD? 

  • May be no signs
  • Quiet wheezes
  • Hyperventilation with prolonged expiration (in prolonged disease)
  • Accessory muscles of respiration used 
  • Hyperinflation of the lungs

15

Why is there hyperventilation with prolonged expiration in COPD? 

Expiratory airflow limitation 

16

What factors are considered when assessing COPD? 

  • History 
  • Chest X-ray
  • FEV1
  • Other lung function tests
  • High resolution CT scan

 

17

What must the history include when assessing COPD? 

The MRC dyspnoea scale

18

What would constitute grade 1 on the MRC dyspnoea scale? 

Not troubled by breathlessness except on strenuous exercise

19

What constitutes grade 2 on the MRC dyspnoea scale? 

Short of breath when hurrying or walking up a slight hill

20

What constitutes grade 3 on the MRC dyspnoea scale?

Walks slower than contemparies on level ground because of breathlessness, or has to stop for breath when walking at own pace

21

What constitutes grade 4 on the MRC dyspnoea scale? 

Stops for breath after walking about 100m, or after a few minutes on level ground 

22

What constitutes grade 5 on the MRC dyspnoea scale? 

Too breathless to leave the house, or breathless when dressing or undressing

23

What other lung function tests are carried out to assess COPD?

  • Lung volumes
  • Loop

 

24

What is the purpose of a chest x-ray in the assessment of COPD? 

Not really to diagnose COPD, mainly to make sure they don't have something else, e.g. cancer 

25

What is the purpose of a high resolution CT scan in the assessment of COPD? 

Detect emphysema 

26

What happens in spirometry? 

The patient fills their lungs from the atmosphere, and breathes out as far and fast as possible through a spirometer 

27

What does simple spirometery allow for? 

Measurement of many lung volumes and capacities 

28

What is the purpose of oxygen therapy? 

To increase oxygen saturation and alleviate symptoms

29

What is oxygen therapy a treatment for? 

Hypoxaemia, not breathlessness 

30

What are the advantages of oxygen therapy? 

  • Long term 
  • Portable 
  • Intermittent 

 

31

How is COPD managed? 

  • Smoking cessation
  • Drug therapy 
  • Oxygen therapy
  • Pulmonary rehabilitation 
  • α1-antitrypsin replacement 

  • Treat co-morbid condition 

 

32

What is the single most useful measure in the management of COPD? 

Persauding the patient to stop smoking 

33

What is the effect of smoking cessation in advanced disease? 

May slow down the rate of deterioration 

34

What is the purpose of drug therapy in the management of COPD?

Used for both the short-term management of exacerbations and the long-term relief of symptoms

35

What drugs are used in the treatment of COPD?

  • Bronchodilators 
  • Corticosteroids
  • Antibiotics 

 

 

36

What kind of drugs are bronchodilators? 

ß2-adrenoagonists 

37

What is the purpose of corticosteroids in the treatment of COPD?

Immunosuppressive

38

What is the purpose of antibiotics in the treatment of COPD?

Shortens exacerbations 

39

When are antibiotics given in COPD?

As soon as sputum turns yellow or green

40

What is meant by pulmonary rehabilitation?

Exercise training

41

What does exercise training do in COPD?

Can modestly increase exercise capacity 

42

How is pulmonary rehabilitation conducted? 

Regular training periods can be used at home

43

Give two examples of exercises that may be used in pulmonary rehabilitation

  • Walking fixed distances 
  • Climbing stairs 

 

44

What are the co-morbidities for COPD? 

  • Cardiac
  • Metabolic 
  • Nutritional
  • Osteoporosis
  • Anxiety/depression