Clinical Features of COPD

Question 1

COPD is a chronic, slowly progressive disorder characterised by

Answer 1

airflow obstruction

Question 2

COPD does not change markedly over

Answer 2

several months

Question 3

In COPD, most of the lung function impairment is

Answer 3

fixed

Question 4

Obstruction in the airways in COPD occurs due to

Answer 4

small airway-narrowing

Question 5

Obstruction of the airways in COPD can be worsened by

Answer 5

inflammation and mucous

Question 6

Are chronic bronchitis and emphysema indicative of COPD?

Answer 6

No

Question 7

Is asthma a cause of COPD?

Answer 7

No - increases likelihood of developing COPD but is not a cause

Question 8

Give a major cause of COPD

Answer 8

Smoking

Question 9

Other than smoking, what are the common causes of COPD?

Answer 9

• passive smoking
• maternal smoking
• air pollution
• occupational

Question 10

What is a rare cause of COPD?

Answer 10

alpha-1-antitrypsin deficiency

Question 11

What is the function of alpha-1-antitrypsin?

Answer 11

Neutralises enzymes released by neutrophils

Question 12

Why does maternal smoking increase the likelihood of the baby developing COPD?

Answer 12

Causes the baby to be born with small lungs and reduced lung function from the start of life, therefore more likely to develop COPD

Question 13

In susceptible smokers with COPD, stopping smoking will not restore the lost FEV1 but it may

Answer 13

revert the subsequent rate of loss to normal

Question 14

What procedure could help to prevent severe or fatal COPD if individuals with reduced lung function could stop smoking?

Answer 14

Screening smokers lung function in early middle age

Question 15

What is the progression of symptoms of COPD?

Answer 15

Symptoms are insidious and gradually worsen over years

Question 16

In diagnosing COPD, what features should be confirmed about breathlessness experienced by the patient?

Answer 16

Gradual onset and little variation of breathlessness

Question 17

In diagnosis COPD, what features of cough and sputum should be present?

Answer 17

• Long history of “smokers cough”
• clear/mucoid sputum
• cough persistent at all times of the year

Question 18

A patient with COPD will typically produce a wheeze when?

Answer 18

On exertion

Question 19

What symptoms indicate severe COPD?

Answer 19

• Weight loss

- Peripheral oedema

Question 20

In smokers, what information is important to acquire when making a diagnosis?

Answer 20

Cigarettes smoked per day, pack years

Question 21

What childhood condition increases the likelihood of developing COPD?

Answer 21

Asthma

Question 22

What muscles might be used during breathing by COPD patients?

Answer 22

Accessory respiratory muscles

Question 23

What symptom is a sign of CO2 retention and may also be a sign of COPD?

Answer 23

Flapping tremor

Question 24

A patient with very severe COPD would have an FEV1 value of what?

Answer 24

FEV1

Question 25

What symptoms would a patient with moderate COPD have?

Answer 25

• Cough
• SOBOE moderate exertion
• FEV1 50-79%

Question 26

What test method would be used to demonstrate fixed airflow obstruction when investigating possible COPD?

Answer 26

Spirometry

Question 27

What treatment when taken long term can improve COPD symptoms?

Answer 27

Long term bronchodilator

Steroid inhalation

Question 28

Significant bronchodilator/steroid response indicates what condition, rather than COPD?

Answer 28

Asthma

Question 29

What might show up on a chest radiograph which could be useful in diagnosing COPD?

Answer 29

• Hyperinflated lung fields
• Flattened diaphragms
• Lucent lung fields
• Bullae

Question 30

What investigatory test would show patients who were chronically hypoxic?

Answer 30

Full blood count

Question 31

Acute exacerbations of COPD are usually precipitated by viral/bacterial infections but another cause may be

Answer 31

• sedative drugs
• pneumothorax
• trauma

Question 32

Acute exacerbation of COPD will increase what symptoms?

Answer 32

• cough
• sputum production
• sputum purulence