COPD Flashcards
What are the risk factors for COPD?
Non-modifiable: age, genetics (alpha 1 trypsin deficiency), low birth weight
Modifiable: smoking, occupational exposure, recurrent infections
Common signs and symptoms
Dyspnoea, chronic cough, sputum production, wheezing, chest tightness, pursed lip breathing, accessory muscle use, barrel chest deformity
What is meant by a pink puffer?
Usually associated with emphysema. It is due to the increased work of breathing due to carbon dioxide retention, leading to muscle wasting and erythematous appearance.
What is the difference between type 1 and type 2 respiratory failure?
Type 1 is characterised by hypoxaemia whereas type 2 has hypoxaemia along with hypercapnia
What is FEV1 and FVC?
FEV1 is the forced excitatory volume in 1 second.
FVC is the full viral capacity, which is a combination of the tidal volume along with forced inspiratory and expiratory volumes
How would you manage COPD?
STOP SMOKING!
Use beta agonists e.g. salbutamol (SABA) or salmeterol (LABA). Also antimuscarinics e.g. ipatropium bromide, theophylline, leukotriene modulators, oxygen therapy as last line
What are some of the complications for COPD?
With chronic bronchitis and emphysema, the V/Q mismatch can lead to vasoconstriction of blood vessels and shunting of blood to more “normal” areas of lung tissue. This can lead to pulmonary hypertension and the consequence of right sided heart failure (cor pulmonale). The respiratory acidosis, is uncorrected with metabolic compensation, can lead to protein dysfunction. The patient is constantly wheezing and dyspnoeic and this can lead to muscle wasting and muscle tiring. If severe enough, patient can become too tired to breathe.
There is often peripheral oedema associated with late stage COPD due to right sided heart failure. The fluid retention can lead to left sided heart failure.
What investigations would you perform?
Spirometry, ABG, FBC, CXR/CT
If suspecting a cardiac cause - ECG
If suspecting infective - sputum culture
