COPD

Question 1

COPD

Answer 1

preventable and treatable characterised by persistent respiratory symptoms and fixed airflow limitation

Question 2

COPD caused by

Answer 2

exposure to noxious particles pr gases - smoking or burning or biomass
silica, coal, microbial plant or animal dusts from clothing
diesel
genetic - a1-antitrypsin deficiency
bronchopulmonary dysplasia
childhood infections

Question 3

COPD is an umbrella term for

Answer 3

emphysema and chronic bronchitis

Question 4

COPDX

Answer 4

case finding 
optimise function 
prevent further deterioration 
develop a care plan 
manage eXacerbations

Question 5

total volume expelled after maximal inhalation

Answer 5

FVC

Question 6

FEV1

Answer 6

volume expelled in the first second of expiration

Question 7

FEV1/FVC

Answer 7

fraction expelled in the first second

<80% bronchodilation

Question 8

pink puffers

Answer 8

mostly emphysema
alveolar destruction predominates
increased residual lung capacity and volume
decreased elastic recoils and diffusion capacity
ventilation perfusion mismatch

Question 9

blue bloaters

Answer 9

chronic bronchitis 
distal airway diseases 
cyanosis and right heart failure 
- cor pulmonale 
diffusion capacity is normal 
tend to be overweight

Question 10

underlying problem of COPD

Answer 10

inflammation
remodelling
destruction go small airways
emphysema of parenchyma inflammation

Question 11

management of stable COPD

Answer 11

exercise 
bronchodilators 
- especially with those matins with measurable reversibility
vaccination 
oxygen tanks

Question 12

SABA example

Answer 12

salbutamol

Question 13

LABA example

Answer 13

salmeterol, formoterol

Question 14

long acting muscarinic antagonists LAMAs example

Answer 14

tiotorpium, glycolyrronium

Question 15

oxygen therapy

Answer 15

long term oxygen therapy at low concentration
15hr/day
improves quality and length of life

Question 16

COPD exacerbations

Answer 16

acute increases is dyspnoea cough and/or sputum
usually due to infection or heart failure
commoner in winter
drive disease progression
associated with increased mortality

Question 17

management of COPD exacerbations

Answer 17

bronchodilators - rescue SABAs
corticosteroids - high dose 
antibiotics - if sputum is purulent 
no sedation 
oxygen