Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Y1 - Respiratory > COPD > Flashcards

COPD Flashcards

(48 cards)

Start Studying
1
Q

What is COPD?

A

A progressive disease characterised by reduced lung function that is not fully reversible and exacerbations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the pathogenesis of COPD?

A

Exposure to noxious particles causes activation of inflammatory cells
These infiltrate the walls of bronchi and bronchioles and release protases
Protases cause inflammation of the airways, alveolar wall destruction and mucociliary dysfunction
Inflammation causes fibrosis and thickening of alveolar walls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some inflammatory cells involved in the pathogenesis of COPD?

A

Macrophages
Neutrophils
Cytokines
Proteases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the two conditions that are components of COPD?

A

Emphysema

Chronic bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is emphysema?

A

Irreversible alveolar wall destruction leading to impaired gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is chronic bronchitis?

A

Mucus hypersecretion
Partially reversible
Causes chronic productive cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does smoking contribute to COPD?

A

By inactivating alpha-1 antitrypsin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the risk factors for COPD?

A 
SMOKING
Alpha-1 antitrypsin deficiency
Toxic gases
Occupational dusts (cadmium, coal)
Low birthweight
Childhood respiratory infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the symptoms of COPD?

A

Daily cough
- Productive or unproductive
- Frequently morning cough but becomes constant as disease progresses
Progressive breathlessness
Wheeze
Cold that seems to ‘settle in the chest’
Frequent lower respiratory tract infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the signs of COPD?

A

Reduced breath sounds
Wheeze
Accessory muscles of respiration are used
Barrel chest (broad deep chest suggesting hyperinflation)
Poor chest expansion
Hyper-resonance
Coarse crackles in exacerbations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the systemic effects of COPD?

A 
Hypertension
Osteoporosis
Depression
Weight loss
Reduced muscle mass with general weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does COPD progress?

A
  1. Progressive airflow obstruction
  2. Impaired alveolar gas exchange
  3. Respiratory failure - decrease in PaO2, increase in PaCO2
  4. Pulmonary hypertension
  5. Right ventricular hypertrophy or failure
  6. Death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is COPD diagnosed?

A

Spirometry - FEV1/FVC <0.7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What investigations are done in exacerbation of COPD?

A 
Careful history
CT scan
Echo
ECG
Sputum culture
Pulse oximetry 
ABG in unwell patients with abnormal pulse oximetry
CXR
FBC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What will spirometry show in COPD?

A

FEV1:FVC ratio is reduced (<70%)
PERF is low
FVC decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the treatment plan for COPD?

A

Breathless without frequent exacerbations: LABA/LAMA
Eosinophils >300: LABA/LAMA/ICS
Frequent exacerbations: trial of LABA/LAMA/ICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What general management should be done in COPD?

A 
Smoking cessation
Influenza and pneumococcal vaccination
Pulmonary rehabilitation
Oxygen
Active lifestyle and exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the ‘asthmatic features or features suggesting steroid responsiveness’:

A

Any previous diagnosis of asthma or atopy
Higher blood eosinophil count
Substantial variation in FEV1 over time
Substantial diurnal variation in PEFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What diseases are associated with COPD?

A 
Ischaemic heart disease
Hypertension
Diabetes
Heart failure
Cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which diseases do COPD patients commonly develop?

Study These Flashcards
A 
Heart failure
Oedema
Respiratory failure
Pulmonary hypertension (cor pulmonale)
Acute exacerbations
21
Q

What are the most common organisms responsible for an acute exacerbation of COPD?

Study These Flashcards
A

Haemophilus influenza (no 1)
Strep pneumoniae
Moraxella catarrhalis
Human rhinovirus

22
Q

Do patients with COPD have higher or lower numbers of goblet cells?

Study These Flashcards
A

Higher

Mucin secreting cells

23
Q

Are the lymphocytes in COPD mainly CD4 or CD8?

24
Q

What are differential diagnoses for COPD?

Study These Flashcards
A 
Heart failure
Asthma
Bronchiectasis
TB
Lung cancer
Left heart failure
Interstitial lung disease
Cystic fibrosis
Idiopathic cough
25
What is an exacerbation of COPD?
Acute worsening of respiratory symptoms that results in additional therapy
26
What are the symptoms of an exacerbation of COPD?
May be precipitated by a viral or bacterial infection Cough Acute bronchospasm (coughing attack, tight chest, difficulty breathing) Increase in sputum suggesting infectious cause
27
What symptom can be used to differentiate COPD from heart failure?
Orthopnoea (breathlessness lying down that goes away sitting up) - not present in COPD
28
What is the GOLD assessment of spirometry?
GOLD 1 - FEV1 >80% - mild GOLD 2 - FEV1 50-79% - moderate GOLD 3 - FEV1 30-49% - severe GOLD 4 - FEV1 <30% - very severe
29
How is spirometry used in COPD?
Used for diagnosis - not beyond that
30
What system is used to assess severity of symptoms in COPD and what does it measure?
mMRC dyspnoea scale - measures severity of breathlessness
31
What are the different grades in the mMRC dyspnoea?
Grade 0 - only breathless with strenuous exercise Grade 1 - short of breath when hurrying on the level or walking up a slight hill Grade 2 - walk slower than people of the same age on the level because of breathlessness or have to stop for breath when walking on my own pace on the level Grade 3 - stop for breath after walking about 100 meters or after a few minutes on the level Grade 4 - too breathless to leave the house or breathless when dressing or undressing
32
What counts as severe exacerbations of COPD?
2+ or 1+ leading to hospital admission in a year
33
What are the 2 main classes of drug used to treat COPD?
Muscarinic receptor antagonists | Beta-adrenoceptor agonists
34
What is the action of muscarinic receptor antagonists?
Block muscarinic M3 ACh receptors to stop bronchoconstriction in airway smooth muscle - cause dilation of airways Reduce bronchospasm Decrease mucus secretion Little effect on progression of disease
35
What are examples of SAMAs?
Ipatropium
36
What are examples of LAMAs?
Tiotropium Glycopyrronium Aclidinium Umeclidinium
37
What is the actin of beta-adrenoceptor agonists?
Bronchodilation
38
What are examples of SABAs?
Salbutamol
39
What are examples of LABAs?
Salmeterol | Formoterol
40
When are ICS useful?
History of hospitalisations for exacerbations of COPD 2+ exacerbations of COPD per year Blood eosinophils >300 History of or concomitant asthma
41
When are ICS avoided?
Repeated pneumonia events Blood eosinophils <100 History of mycobacterial infection
42
What is the management for an exacerbation of COPD?
``` Increased short acting bronchodilators Systemic steroids (prednisolone, no longer than 5 days) Antibiotics only when indicated (5-7 days) - Amoxicillin, doxycycline, clarithromycin ```
43
When should you refer a COPD patient to secondary care?
Diagnosis uncertain Rapidly declining FEV1 Consideration of LVRS (lung volume reduction surgery), bronchoscope valves or transplant Exacerbation in elderly, frail or patients where home support is not sufficient
44
What treatment is used in hypercapnia respiratory failure?
Non-invasive ventilation (NIV)
45
How does non-invasive ventilation work?
Lowers the work of breathing to reduce pCO2
46
What are the surgical options for treatment of COPD?
Bullectomy Lung volume reduction surgery Endobronchial valves and coils Lung transplant
47
When are patients given long term oxygen?
Patients with confirmed COPD who have stopped smoking for 3 months With SaO2 <92% on 3 separate occasions spaced over 2 months, outwith exacerbations Optimise COPD management and reassess - if still <92% refer to clinic for LTO
48
When would antibiotics be warranted in an exacerbation of COPD?
Fever | Abnormal observations

Y1 - Respiratory (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions