36: COPD - Hilgerson Flashcards
definition of COPD
a disease state characterized by airflow limitation that is not fully reversible. the airflow limitation is progressive and associated with abnormal inflammatory response of lung to noxious particles or gases
key difference b/w COPD and asthma
COPD is progressive
most significant risk factor for COPD
tobacco
present in 90% of cases
subjective findings for COPD
- SOB/DOE and cough
- increased sputum production volume
- increased purulence of sputum
- history of exposure to risk factors
describe a person with COPD in your exam room
thin person sitting upright, leaning forward with pursed lips
cachectic, wasted, blue, baggy
PE finding with COPD
- tachypnea with accessory muscle use
- hperinflation
- hyperresonance with percussion
- wheezes, rhonchi, decreased breath sounds
CXR findings for COPD
- low flat diaphragm and long narrow heart
- increased retrosternal airspace on lateral
key diagnostic tool for COPD
spirometry
short acting bronchodilator
beta-2 agonist = albuterol
short-acting anticholinergic
ipratropium bromide aka atrovent
long acting anticholinergic
spiriva aka tiotropium
long acting beta2agonist
salmeterol
treatment for severe COPD-
- short and long acting bronchodilators
- inhaled corticosteroid (fluticasone)
- pulmonary rehab
- O2
O2 necessity criteria
p02 less than 55 on room air
pO2 56-59 with cor pulmonale or secondary erythrocytosis
spO2 less than 88 at rest or walking **
3 major criterion for COPD exacerbations
- increase in sputum volume
- presence of sputum purulence
- worsening dyspnea
–> severe type1 if have all 3 , moderate with 2, mild if one and other symptom
