COPD

Question 1

What is it

Answer 1

COPD is characterised by airflow obstruction which is progressive in severity. not fully reversible. umbrella term for emphysema, chronic bronchitis- can occur without airflow obstruction, asthma

Question 2

inflammation and symptoms in COPD

Answer 2

systemic inflammation- leads to problems alongside lung inflammation. other symptoms- weight loss, skeletal muscle dysfunction, cardiovascular disease, osteoarthritis, depression and fatigue, cancer

Question 3

normal airway clearance

Answer 3

airways line by- cells which produce mucus, tiny hair cells called cilia which continually beats. mucus traps dust particles and bacteria. the cilia move the mucus along until it reaches the throat, and we swallow it or cough. defence mechanisms

Question 4

what can go wrong with airway clearance

Answer 4

In COPD and bronchiectasis excess mucus is produced, mucus is thicker and stickier. the cilia are unable to beat, smoking paralyses the cilia. therefore, dust and bacteria stay trapped in the airways. mucus builds up providing a warm moist environment for bacteria to grow- recurrent chest infection

Question 5

whatsis bronchitis

Answer 5

chronic disease of lungs where bronchi become inflamed. the inflammation causes mucus to be produced, which narrows the airways and makes breathing more difficult. increased sputum production- over production of mucus in the airways which becomes difficult to clear

Question 6

bronchitis symptoms

Answer 6

wheezing is common especially after coughing. this Is because the inflamed airways may narrow for short period. this reduces the amount of air that enters the lungs. airways may be inflamed. airways are narrower with less space for sputum to get through. as a result, may feel unwell, tired and unable to cough

Question 7

what is emphysema

Answer 7

a condition where the alveoli of the lungs become inflamed and lose their natural elasticity. they love expand and lose their ability to fill/ contract properly. as air fills up in these sacs, some rupture and become one sack reduce SA for gas exchange. when you breath out, the trapped air cannot be released and breathing becomes more difficult

Question 8

what asthma

Answer 8

an episodic increase in airway obstruction caused by various stimuli resulting in increased airway resistance. it is reversible. inflammation and bronchoconstriction. airways are sensitive- become irritated, inflamed and narrow= reduce airflow

Question 9

symptoms of asthma

Answer 9

breathlessness, wheeze, tightness of chest

Question 10

why is asthma classed as COPD

Answer 10

often reversible in airway disease but can become chronic with some fixed airway damage therefore comes under COPD umbrella

Question 11

causes of COPD

Answer 11

cigarette smoking (90%)- significant history 20 pack years or more (number of packs per day*number of Yeats smoking), occupational exposure- coal miners, alpha-1 antitryspin deficiency, social deprivation

Question 12

diagnosis of COPD

Answer 12

detailed patient history. clinical signs- breathlessness on exertion, cough, increased sputum, risk factors, rule out other cases
spirometry- diagnose, categorise severity, monitor progression
CXR

Question 13

classification- early

Answer 13

often few symptoms, morning cough, chest infections in winter, breathlessness when exercising vigorously. clinical examination may be normal although spirometry may be reduced

Question 14

classification- moderate

Answer 14

range of respiratory symptoms. cough, wheeze, SOB with moderate exertion, clinical examination may reveal wheeze, barrel chest, flattened diaphragm on CXR

Question 15

classification- severe

Answer 15

cyanosis, weight loss, raised JVP, peripheral oedema

Question 16

treatment

Answer 16

smoking cessation, 4X more likely to quit with help/ advice and nicotine replacement, stop smoking services are widely available in the community, stopping smoking will help to slow the progression of the disease, we can refer as physios at any time

Question 17

medication

Answer 17

inhalers, steroids and antibiotics, mucolytics, flu and pneumonia vaccines

Question 18

pulmonary rehabilitation

Answer 18

exercise, education, self management, diet, lifestyle modification, will help to reduce admissions and aid recovery time post exacerbation

Question 19

summary

Answer 19

COPD is an obstructive disease, management is a combination of education, medication, exercise, early diagnosis is key to effective management, physio can have a large positive impact on these patients experiences and management of their conditions