COPD

Question 1

What is COPD defined as?

Answer 1

Chronic respiratory symptoms and permanent airflow limitation.

Question 2

What are some symptoms of COPD?

Answer 2

• Persistent breathlessness
• Chronic cough
• Chronic phlegm production
• Chest tightnesand SOB
• Wheeze

Question 3

What does spirometry measure?

Answer 3

FVC (total volume expelled after max inhalation) and FEV1 (volume expelled in first second)

FEV1/FVC <0.7 and <0.8 after bronchodilation suggests fixed airflow limitation/

Question 4

How does smoking affect the lungs?

Answer 4

Causes airway inflammation and remodelling, as well as lung parenchymal inflammation, causing decreased recoil.

Question 5

Describe ‘pink puffers’ vs ‘blue bloaters’

Answer 5

Pink puffers = emphysema.
Alveolar destruction causes increased residual lung volume. There is a ventilation/perfusion mismatch due to alveolar destruction.

People are pink, as they expend a lot of energy on rapid breathing.

Blue bloaters = chronic bronchitis
Distal airway disease. Diffusion capacity is normal, but cause right heart failure and cyanosis (blue). Tend to be overweight.

Question 6

How does inflammation affect large and small airways, and parenchymal tissue?

Answer 6

Large airway inflammation = remodelling
Small airway inflammation = remodelling and destruction
Parenchymal inflammation = destruction and emphysema

Question 7

Strategies to manage COPD?

Answer 7

• Bronchodilators
• Corticosteroids to control inflammation
• Antibiotics if sputum is purulent
• Ventilatory assistance