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Respiratory > 1(E): COPD Exacerbation > Flashcards

1(E): COPD Exacerbation Flashcards

1
Q

What is a COPD exacerbation

A

Acute increase in symptoms of COPD

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2
Q

What time of year are COPD exacerbations more common

A

Winter

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3
Q

Are bacterial or viral causes of COPD exacerbation more common

A

Bacterial (80%)

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4
Q

What is the most common cause of COPD exacerbation

A

H. Influenza

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5
Q

What 3 bacteria cause infective exacerbation of COPD

A

H. Influenza
S. Pneumonia
Morexella catarrhalis

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6
Q

What viral infection causes infective exacerbation of COPD

A

Rhinovirus

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7
Q

What are symptoms of COPD

A

Dyspnoea
Productive cough
Wheeze
Hypoxia

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8
Q

What investigations are ordered in exacerbation of COPD

A
  • Obs
  • ABG
  • CXR
  • MC+S
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9
Q

What is first-line management for acute exacerbation of COPD

A

Nebulised salbutamol and ipratropium bromide

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10
Q

What is second-line for acute exacerbation of COPD

A

Oxygen

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11
Q

How is oxygen given in acute exacerbation of COPD

A

Venturi mask

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12
Q

What SpO2 is aimed for in acute exacerbation of COPD

A

88-92

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13
Q

What is third-line in acute exacerbation of COPD

A

Steroids: IV hydrocortisone and prednisone

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14
Q

What antibiotics are given in acute exacerbation of COPD

A

Amoxicillin

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15
Q

If an individual is penicillin allergic, what is second-line to amoxicillin

A

Clarithromycin or Doxycycline

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16
Q

If no response to management thus far in exacerbation-of COPD, what is given

A

Theophylline

17
Q

What conservative measures are used in management of COPD

A

Physiotherapy - to aid mucus clearance

18
Q

If no response to aminophylline, what is considered

A

Non-invasive positive pressure ventilation

19
Q

What are indications for non-invasive ventilation

A
  • RR >30
  • pH <7.35
  • Increasing pCO2
20
Q

If patients are not suitable for mechanical ventilation, what is offered

A

Respiratory stimulant drug (IV Doxepram)

21
Q

What are indications for intubation and ventilation

A

pH <7.26 or pCO2 rising despite optimal medical management

Respiratory (19 decks)

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