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Respiratory System > Clinical Features of COPD > Flashcards

Clinical Features of COPD Flashcards

1
Q

COPD definition

A

Lung disease characterised by chronic obstruction of lung airflow

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2
Q

Diseases included within COPD

A

Chronic bronchitis

Emphysema

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3
Q

COPD symptoms are due to

A

Airway and/or alveolar abnormalities caused by significant exposure to noxious particles or gases

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4
Q

Risk factors of COPD

A 
Smoking (no.1)
Occupation
Age
Lower socioeconomic status
Asthma/airway hyper-reactivity
Childhood infection
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5
Q

Is COPD more common in men or women

A

Women

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6
Q

Alpha-1 antitrypsin

A

Protease inhibitor made in the liver

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7
Q

Function of alpha-1 antitrypsin

A

Limits damage caused by activated neutrophils releasing elastase in response to infection/cigarette smoke

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8
Q

Effect of alpha-1 antitrypsin deficiency

A

Alveolar damage and emphysema

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9
Q

Percentage of smokers that develop COPD

A

<50%

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10
Q

Common symptoms of COPD

A 
Shortness of breath
Recurrent chest infections
Ongoing cough
Sputum
Wheeze
Chest tightness
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11
Q

Less common symptoms of COPD

A 
Weight loss
Fatigue
Decreased exercise tolerance
Ankle swelling (heart failure)
Cor pulmonale
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12
Q

Examination findings in COPD

A 
Cyanosis
Raised JVP
Cachexia
Wheeze
Pursed lip breathing
Hyper-inflated chest
Use of accessory muscles
Peripheral oedema
Flapping tremor
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13
Q

mMRC breathlessness scale

A

0-4, 0 being breathlessness with strenuous exercise, 4 being too breathless to leave the house

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14
Q

Diagnosis criteria

A 
Typical symptoms
Aged > 35
Presence of risk factor
Absence of clinical features of asthma
Airflow obstruction confirmed by spirometry
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15
Q

Spirometry of stage 1 COPD

A

80%

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16
Q

Spirometry of stage 2 COPD

A

50-79%

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17
Q

Spirometry of stage 3 COPD

A

30-49%

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18
Q

Spirometry of stage 4 COPD

A

<30%

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19
Q

Spirometry demonstrates

A

Lack of reversibility

20
Q

Spirometry in restrictive disorder

A

Ratio is normal as both FEV1 and FVC reduced

21
Q

Signs on chest x-ray of COPD

A 
Vascular hila
Hyperinflation
Bulla
Small heart
Flat diaphragm
22
Q

How many people are living with COPD in the UK

A

1.2 million (2% pop)

23
Q

How common is COPD out of all lung diseases

A

2nd most common

24
Q

Is the prevalence of COPD increasing or decreasing

A

Increasing

25
Q

How many people are diagnosed with COPD each year in the UK

A

115,000

26
Q

Are incidences of COPD increasing or decreasing

A

Decreasing

27
Q

Onset of COPD compared to asthma

A

In mid-life whereas asthma in early life

28
Q

Progressiveness of symptoms of COPD

A

Slowly progressive

29
Q

People with COPD usually have a history of

A

Tobacco smoking or exposure to other types of smoke

30
Q

If unsure if asthma or COPD, carry out

A

Pulmonary function tests - lung volumes and transfer factor

31
Q

Residual volume in COPD

A

Increases

32
Q

Total lung capacity in COPD

A

Increases

33
Q

RV/TLC

A

> 30%

34
Q

Gas transfer in COPD

A

Reduces

35
Q

Diffusion of carbon monoxide in COPD

A

Decreases

36
Q

Carbon monoxide transfer coefficient abundance in COPD

A

Decreases

37
Q

Radiology to differentiate between COPD and asthma

A

High resolution computed tomography (HRCT)

38
Q

Differential finding in HRCT in COPD

A

Upper zone emphysema

39
Q

2 main things that differentiate COPD and asthma

A

Diurnal variability and reversibility with bronchodilators

40
Q

Management of acute exacerbations in primary care

A

Change in inhalers
Oral steroids (prednisolone)
Antibiotics

41
Q

Acute exacerbation in secondary care triggers

A

Viral/bacterial infection
Sedative drugs
Trauma

42
Q

Treatment of acute exacerbations in secondary care

A

Oxygen
Nebulised bronchodilator
Oral/IV corticosteroids
Antibiotics

43
Q

Factors used to measure severity

A

Spirometry
Nature and magnitude of symptoms
History of moderate and severe exacerbations and future risk
Presence of co-morbidity

44
Q

How much does NHS spend on prescribed inhalers each year

A

£10 million

45
Q

Number of deaths from COPD worldwide annually

A

3 million

46
Q

Predicated COPD related deaths worldwide annually in 2030

A

4.5 million

47
Q

Number on thing patients can do to slow progression of COPD

A

Stop smoking

Respiratory System (20 decks)

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