Management of COPD Flashcards

1
Q

Which form of COPD is Airflow obstruction Hyperinflation?

A

Chronic Bronchitis Emphysema

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2
Q

Is COPD reversible?

A

Not fully It is also preogressive

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3
Q

What are the symptoms of COPD?

A

Breathlessness Cough Recurrent Chest infection (frequent ‘winter bronchitis) Sputum productions Wheeze/Chest tightness Usually in people aged 35 and older

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4
Q

Why do people develop COPD?

A

Reactive oxygen species Cause tissue damage and deactivate antiproteases (increase in neutrophil elastase) more tissue damage

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5
Q

What are the other health effects of COPD?

A

Loss of muscle mass - TNF interleukin affected - less drive to eat food Exercise ability is very poor Weight Loss Cardiac disease Depression, anxiety etc

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6
Q

What is the 3rd leading cause of death in the world?

A

COPD

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7
Q

How do you diagnose COPD?

A
  • Relevant History (Symptoms) • Look for clinical signs • Confirmation of diagnosis and assessment of severity • Other relevant tests
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8
Q

What are the clinical differences between COPD and ASTHMA? Use the headings: Age, Cough, Smoking, breathlessness, nocturnal symptoms, family history, concomitant eczema or allergic rhinitis

A
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9
Q

What are the examinations for COPD?

A

No diagnostic tests

May be normal in early stages

Reduced chest expansion

Prolonged expiration/Wheeze

Hyperinflated chest

Respiratory failure

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10
Q

What are the different ways you can witness respiratory failure?

A

• Tachypneoa

  • Cyanosis
  • Use of accessory muscles
  • Pursed lip breathing
  • Peripheral Oedema

Ankle swelling too, because lots of strain on the right side of the heart

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11
Q

What is the use of spirometry in COPD?

A

COnfirms diagnosis and assesses severity

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12
Q

How do you analyse the results of a spiromtry to confirm COPD?

A
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13
Q

How do you assess the severity of COPD usinf FEV1/FVC?

A
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14
Q

What are the COPD baseline tests?

A

Anaemia can present itslef as breathlessness

HIgh blood cell count can be a sign of COPD

Polycthaemic means lots of RBC’s

AIAT is antitrypsin

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15
Q

LOOK

A
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16
Q

What are the ways you can manage COPD?

A

Prevention of disease progression

Releive breathlessness

Prevention of exacerbation

Management of complications

17
Q

What is the interventions for the following aims?

Prevention of disease progression

Releive breathlessness

Prevention of exacerbation

Management of complications

A

Prevention of disease progression - Smoking cessation

Releive breathlessness - Inhalers

Prevention of exacerbation - Inhalers, Vasccines, Pulmonary Rehabilitation

Management of complications - Long term Oxygen therapy

18
Q

What vaccines can help prevent exacerbation?

A

– Annual Flu vaccine

– Pneumococcal vaccine

19
Q

What is the non-pharmacological management of COPD?

A
20
Q

What does pulmonary rehabilitation involve?

A
21
Q

What are the benefits of Pulmonary Rehabilitation?

A
22
Q

What are the benefits of Pharmacological Management?

A

– Relieve symptoms
– Prevent exacerbations

– Improve quality of life

23
Q

What are the short acting bronchodilators used for inhaled therapy in COPD?

A
24
Q

What are the long acting bronchodilators used to treat COPD?

A

– Relieve symptoms
– Prevent exacerbations – Improve quality of life

25
Q

What are examples of High dose inhaled corticosteroids (ICS and LABA)

A
26
Q

How does the COPD inhaler treatment progress with severity, symptoms and exacerbation?

A
27
Q

What is QALY?

A

A measurement used to measure one year of good quality life

28
Q

What are the most expensive treatment methods for COPD per QALY?

A
29
Q

Who benefits from long term oxygen therapy?

A

People who are hypoxic to the point of

30
Q

LOOK

A
31
Q

What are the symptoms of COPD exacerbation?

A
32
Q

What is the effect of AECOPD on alveoli and mucus glands (including goblet cells)?

A

Alveolar wall destruction and mucus hypersecretion

33
Q

What does management of AECOPD involve?

A

Short acting bronchodilators (salbutamol/ipratropium/nebulisers)

Steroids (Prednisolone 40mg per day for 5-7 days)

Antibiotics (only if there is evidence of infection: Fever, increase in volume/purulence of sputum)

Hospital admission if unwell (tachypnea, low oxygen saturation (below 90-92 %)Hypotension.

34
Q

What are the relevant AECOPD investigations?

A

Full blood count

Biochemistry of glucose

Theophyline concentration (in patients using theophyline concentration)

Arterial blood gas

Electrocardiograph

Chest X-Ray

Blood cultures in febrile patients

Sputum Microscopy, culture and sensitivity