Clinical features of COPD Flashcards
Define COPD
A lung disease characterised by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible
What symptoms are needed for diagnosis of chronic bronchitis
Cough + sputum for at least 3 months over 2 consecutive years
Define emphysema
Structural changes in alveoli which cause them to ‘disintegrate’
Is incidence of COPD increasing or decreasing
Decreasing
Do more males or females suffer from COPD
Males
How many people in the UK suffer from COPD
1.2 million
What are the modifiable risk factors of COPD
- smoking and pollutants
- Higher prevelance in lower income countries due to biomass cooking and heating
- Air pollution
- Occupational exposure to dust/fumes
What are the non-modifable risk factors of COPD
- Sex
- Age
- Low-socioeconomic status
- Pre-existing asthma
- Chronic bronchitis
- recurring childhood infection
- Alpha-1 antitrypsin deficiency
What are the common symptoms of COPD?
- Cough
- Breathlessness
- Sputum production
- Frequent chest infections
- Wheezing
What are the non-common symptoms of COPD?
- Weight loss
- Fatigue
- Swollen ankes
What does grade 0 mean on the mMRC dysnopea scale
I only get breathless with strenuous exercise
What does grade 1 mean on the mMRC dysnopea scale
I get short of breath when hurrying on level ground or walking up a slight hill
What does grade 2 mean on the mMRC dysnopea scale
On level ground, i walk slower than most people of the same age because of breathlessness or have to stop for breath when walking at my own pace
What does grade 3 mean on the mMRC dysnopea scale
I stop for breath after walking about 100 yards or after a few minutes on level ground
What does grade 3 mean on the mMRC dysnopea scale
I am too breathless to leave the house or i am breathless when dressing
What criteria need to be met to diagnose COPD?
- Typical symptoms
- Over 35 years
- Presence of risk factor (smoking or occupational exposure)
- Absence of clinical features of asthma
What symptoms are worsened in an exacerbation of COPD?
- SOB
- Wheeze
- Chest tightness
- Cough
- Sputum - purulence/volume
What are the signs of a severe exacerbation of COPD?
- Breathlessness (RR>25 per min)
- Accessory muscle use at rest
- Purse lip breathing
- Cyanosis
- Significant decrease in exercise tolerance
- Signs of sepsis
- Fluid retention
- Confusion
What is used to measure severity in COPD
- Nature and magnitude of symptoms
- History of moderate and severe exacerbations and future risk
- Presence of co morbidity
Compare type 1 and type 2 respiratory failure
Type 1: decreased PO2
Type 2: decreased PO2 and increased pCO2
Describe cor pulmonale
right sided heart failure due to lung disease
Is COPD a cause in finger clubbing?
Nope
What spirometry reading is used to diagnose COPD?
FEV1/FVC ration of <0.7
