COPD Flashcards
Symptoms?
Dyspnoea, cough +/- sputum
Which cells are recruited?
Neutrophils, CD8-T cells, macrophages and fibroblasts
What is the difference in spirometry results between restrictive and obstructive disease?
Restrictive: impaired volume spirometry
Obstructive: impaired flow spirometry
What pathological process is caused by fibroblasts?
Abnormal tissue repair
Where does narrowing start?
In the periphery near the alveoli (<2mm)
What causes the ‘barrel chest’?
Hyperinflation and gas trapping due to incomplete expiration
TGF-beta and other growth factors cause what in COPD?
Airway fibrosis
Genetic absence of anti-protease alpha-1 anti-trypsin leads to what?
Early-onset COPD
Percussion of COPD?
Hyper-resonant
Auscultation of COPD?
Distant breath sounds (hyperinflation)
Poor air movement (loss of tissue elasticity and tissue breakdown)
Wheeze (airway inflammation and resistance)
Coarse crackles (mucus in airway - either inflammation or exacerbation)
What added complications will cor pulmonale cause for the COPD patient?
Cyanosis Loud P2 Hepatojugular reflux Heptosplenomegaly Lower-extremity swelling Distended neck veins
Which COPD patients may present with clubbing?
Those who have developed secondary bronchiectasis or lung cancer
What is the definition of a COPD exacerbation?
Acute worsening of symptoms requiring additional treatment
What examination finding can hypercapnia cause?
Asterixis (hand flap)
What finding is required for diagnosis?
Obstructive spirometry
FEV1/FVC
< 0.7
Mild COPD:
FEV1 > or equal to 80%
Moderate COPD:
FEV1 = 50-79%
Severe COPD:
FEV1 = 30-49%
Very severe COPD:
FEV1 < 30%
Which spirometry values increase with COPD?
Functional residual capacity and residual volume
Which spirometry value decreases with COPD?
Inspiratory reserve volume
When would a COPD patient be exercise limited?
Once the inspiratory reserve volume is within 0.5L of the total lung capacity
What causes gas trapping?
Airway collapse (equal pressure point reached before cartilage)
