COPD Flashcards Preview

Maddie’s Resp > COPD > Flashcards

Flashcards in COPD Deck (16)
Loading flashcards...
1
Q

Describe COPD. (5)

A

A progressive airway obstruction that is not reversible and exhibits no marked change over months. It encompasses chronic bronchitis and emphysema, and is primarily caused by smoking.

2
Q

Describe emphysema. (5)

A

Destruction of the terminal bronchioles to bullae which reduces air spaces available for gas exchange. Bronchioles collapse during expiration due to lack of radial traction causing obstruction, and loss of elastic tissue means the chest wall’s recoil is unopposed, leadings to hyperinflation and barrel chest.

3
Q

Describe chronic bronchitis. (3)

A

Chronic mucus hypersecretion caused by inflammation of the large airways (often smoking related). Causes a productive cough and frequent infections.

4
Q

Describe the causes of COPD. (4)

A

Smoking
Genetics - alpha 1 antitrypsin deficiency
Occupational - coal dust inhalation
Pollution

5
Q

Describe the symptoms of COPD. (3)

A

Productive cough
Breathlessness
Excerbations make both worse.

6
Q

Describe the signs of COPD. (7)

A

Often none.
“Purse lip” breathing - increased pressure within airways to delay collapse
Tachypnoea
Use of accessory muscles like SCM
Barrel chest - hyperinflation
Wheeze or quiet breath sounds
If severe: cor pulmonale, CO2 retention flap, cyanosis.

7
Q

Describe the MRC Dyspnoea score (6)

A

Grade of breathlessness related to activity level.

  1. Only on strenuous exercise
  2. Hurrying or walking uphill
  3. Walking at normal pace
  4. Has to stop for breath when walking
  5. Too breathless to leave house, breathless on dressing.
8
Q

Describe the outflow obstruction measurements that are essential for diagnosis with COPD. (5)

A

FEV1 <80% of expected
Mild: FEV1 50-80% expected
Moderate: FEV1 30-49% expected
Severe: FEV1 <30% expected.

FEV1/FVC ratio <70%

9
Q

Describe the diagnostic criteria for COPD (6)

A

Smoker or ex-smoker
>40 with recent onset of symptoms
Alpha 1 anti-trypsin deficiency diagnosed
Chronic productive cough
Persistent and progressive breathlessness
Spirometry: FEV1<80% predicted, FEV1/FVC <70%.

10
Q

Describe other tests you would perform to help assess COPD. (3)

A

CXR to rule out other things
High res CT to assess damage in emphysema
ABG to assess respiratory failure

11
Q

Describe some pharmacological managements for stable COPD and some draw backs of these. (11)

A

Bronchodilators - beta 2 agonists block smooth muscle contraction. Can cause tachycardia and tremors.

Anticholinergics - blocks ACh transmission causing smooth muscle contraction. Can cause AF, urinary retention, constipation, cough.

Steroids - prevents cAMP destruction so leads to smooth muscle dilation. Can cause SVT, diabetes, seizures, fluid retention.

Mucolytics - reduced thickness of sputum to help clearing.

12
Q

Deascribe the most important thing to do when treating COPD. (1)

A

Smoking cessation.

13
Q

Describe some supportive treatments for stable COPD (2)

A

Flu vaccines

Diet

14
Q

Describe three more drastic treatment options for stable but very severe COPD. (8)

A

Pulmonary rehabilitation - makes breathless patients get up and do stuff so they don’t get more breathless due to muscle wastage.
Long term oxygen therapy - can help reduce mortality if over 16 hours a day, but an obvious fire risk so only for non-smokers.
Surgery - lung volume reduction or transplant (if young enough).

15
Q

Describe the manament of an exacerbation of COPD. (5)

A
Target sats to 88-92% 
Nebulised bronchodilators
Steroids
Treat infection if indicated
ABG repeats every two hours.
16
Q

Describe the treatment of exacerbated COPD if the ABG indicated acidosis or respiratory failure. (6)

A

Non-invasive ventilation - CPAP or BIPAP - pressures through a mask used to prevent collapse of airways.
Patient muct: be conscious, facial injury, vomiting, pneumothorax, upper airway secretions.
If not suitable uses invasive ventilation.