Management of COPD Flashcards
What does COPD stand for
Chronic Obstructive Pulmonary Disease
What is COPD
A combination of airflow obstruction and hyperinflation that is progressive and not fully reversible
Name a cause of airflow obstruction
Chronic bronchitis which is not fully reversible
What is chronic bronchitis
It causes thick sticky mucus to block up the airways and inflammation and swelling to further narrow the airway
Name a cause of hyperinflation
Emphysema
What does emphysema cause
Air exchange to become difficult in damaged alveoli causing air to become trapped
Name the symptoms of COPD
Breathlessness
Cough and recurrent chest infection
Name a cause of COPD
Smoking
How can smoking lead to the development of COPD
Tobacco in cigarettes releases a reactive oxygen species (‘free radicals’)
This causes the inactivation of antiproteases leading to an increase in neutrophil elastase
Tissue damage occurs leading to emphysema
What other things can increase neutrophil elastase
Nicotine in tobacco
IL-8 and TNF from free radicals
Both cause the release of neutrophils causing an increase in neutrophil elastase
What can a cogenital α1AT deficiency cause to occur
Increase neutrophil elastase leading to tissue damage
What can an increase in macrophage elastase and metabolic proteinases lead to
Tissue damage
What are some other outcomes of COPD (non-respiratory)
Loss of muscle mass
Weight loss
Cardiac disease
Depression, anxiety etc.
What are the two main respiratory illnesses which COPD can cause
Emphysema
Chronic bronchitis
How many people in the UK are affected with COPD
1 million with a further 2 million undiagnosed
How many people in the UK die from COPD
30,000
By 2020 it will be the 3rd leading cause of death in the UK although it is largely preventable
How can COPD be diagnosis
Relevant history (symptoms)
Look for clinical signs
Confirmation of diagnosis and assessment of severity
Other relevant tests
What type of symptoms will cause the suspicion of COPD
Patients aged 35 or more Current or former smokers Chronic cough Exertional breathlessness Sputum production Frequent ‘winter’ bronchitis Wheeze/chest tightness
What are the differences between COPD and asthma
See table 3.5 in notes
What features may be seen when examining for COPD
Early stages may be normal Reduced chest expansion Prolonged expiration/wheeze Hyperinflated chest Respiratory failure
What features may be seen upon examination for respiratory failure
Tachypneoa Cyanosis Use of accessory muscles Pursed lip breathing Peripheral Oedema
How can COPD be diagnosed
Through clinical history, examination and spirometry
What will a clinical history show in COPD diagnosis
Cough
Breathlessness
Chest infections
Winter bronchitis
What will an examination show in COPD diagnosis
May be normal
Tachypnoea
Wheeze
Hyperinflated chest
