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Flashcards in COPD Deck (19)
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1

What is COPD?

Chronic disorder of airflow obstruction

2

What conditions make up COPD?

Emphysema and chronic bronchitis

3

What is emphysema?

Enlarged airspaces due to alveolar wall destruction - loss of elastin due to increased protease activity

4

What are features of chronic bronchitis?

Cough with sputum production most days for 3 months in 2 successive years

5

What is the pathophysiology of COPD?

Mucous gland hyperplasia
Loss of cilia
Chronic inflammation
Fibrosis of small airways

6

What causes COPD?

Smoking
Occupational exposure
α-1-antitrypsin deficiency

7

What are symptoms of COPD?

Cough
Dyspnoea
Wheeze

8

What do you find on examination of COPD?

Barrel chest
Decreased chest expansion
Hyper resonant percussion
Reduced breath sounds
Inspiratory crackles

9

What is the spirometry pattern?

Obstructive

FEV1 < 80% of predicted
FEV1/FVC <0.7

10

How is COPD classified?

Mild - FEV1 50-80% of predicted

Moderate - FEV1 30-49%

Severe - FEV1 <30%

11

How do you manage COPD conservatively?

Smoking cessation
Weight loss
Influenza vaccinations
Pulmonary rehabilitation

12

How do you manage mild COPD?

Anti-muscarinic PRN
B2 agonist PRN

13

How do you manage moderate COPD?

Regular anti-muscarinic OR LABA

+/- inhaled corticosteroid

14

How do you manage severe COPD?

Regular SABA
Anticholinergic

15

When is Long term oxygen therapy offered?

pO2 consistently <7.3
Non-smoker
Not retain CO2

16

How do you classify barrel chest on an x-ray?

>8 anterior ribs OR >10 posterior ribs

17

How do you evaluate baseline?

MRC dyspnoea scale

COPD assessment test

18

What is the MRC dyspnoea scale?

1 Not troubled by breathless except on strenuous exercise
2 Short of breath when hurrying on a level or when walking up a slight hill
3 Walks slower than most people on the level, stops after a mile or so, or stops after 15 minutes walking at own pace
4 Stops for breath after walking 100 yards, or after a few minutes on level ground
5 Too breathless to leave the house, or breathless when dressing/undressing

19

What is the COPD assessment test?

Tool to assess how COPD affects every day life

Cough
Phlegm
Walking
Daily activities
Leaving house
Sleep
Energy