COPD Flashcards
What is COPD made up of?
Chronic Bronchitis and Emphysema
Name some features of chronic bronchitis?
Chronic neutrophilic inflammation Mucus hypersecretion Mucociliary dysfunction Altered lung microbiome Smooth muscle spasm and hypertrophy Partially reversible
Name some features of Emphysema?
Alveolar destruction
Impaired gas exchange
Loss of bronchial support
Irreversible
What are the symptoms of COPD?
Smoking Non-atopic Daily productive cough Progressive breathlessness Frequent infective exacerbations Chronic bronchitis- wheezing Emphysema- reduced breath sounds
Name the 6 steps of the chronic cascade in COPD?
- Progressive fixed airflow obstruction
- Impaired alveolar gas exchange
- Respiratory failure: ¯PaO2 PaCO2
- Pulmonary hypertension
- Right ventricular hypertrophy/failure (i.e. cor pulmonale)
- Death
What is ACOS?
Asthma and COPD combined
COPD with blood eosinophilia > 4%
Responds better to ICS wrt exacerbation reductions
More reversible to salbutamol
What may inhaled corticosteroids cause in COPD?
pneumonia - due to local immune suppression & impaired mucociliary clearance
In COPD, are ICS effective as monotherapy?
NO - use with a LABA
What is the best treatment for COPD?
beclometasone/formoterol = ICS + LABA (salmeterol)
What other treatments are avaliable for COPD?
- Smoking cessation
- Immunisation
- Pulmonary rehab
- Oxygen
How is the FVC in COPD?
Impaired
