COPD

Question 1

What is the definition of COPD?

Answer 1

Airflow obstruction, usually progressive, not fully reversible and does not change markedly over several months

Question 2

What are the risk factors for COPD?

Answer 2

Smoking, genetic factors, increased age, male, environment and occupational pollutants

Question 3

What is the presentation of COPD?

Answer 3

Breathlessness, wheeze, productive cough, frequent chest infections

Question 4

What are the causes of COPD?

Answer 4

Smoking, inherited alpha 1 antitrypsin deficiency, industrial exposure e.g. soot

Question 5

What are the types of COPD?

Answer 5

Chronic bronchitis

Emphysema

Question 6

What is chronic bronchitis?

Answer 6

Chronic bronchiole inflammation, increased mucus, inflammation leading to permanent damage + airway narrowing, chronic productive cough

Question 7

What is emphysema?

Answer 7

Alveolar wall damage, larger alveoli, can’t support bronchioles leads to collapse

Question 8

What are the investigations for COPD?

Answer 8

Spirometry - obstructive pattern <0.7

CXR - hyperinflation

Question 9

What is the management for COPD?

Answer 9

Smoking cessation, pulmonary rehab, bronchodilators, antimuscarinics, steroids, possible long term oxygen therapy

Question 10

What are the complications of COPD?

Answer 10

Resp infections, cor pulmonale, lung cancer, resp failure, polycythaemia

Question 11

What is cor pulmonale?

Answer 11

Right sided HF secondary to COPD
Caused by chronic hypoxia and subsequent vasoconstriction in pulmonary vasculature that causes pulmonary hypertension and right sided HF

Question 12

What is the treatment for COPD exacerbation?

Answer 12

NEBs - salbutamol and ipratropium
Steroids - prednisone STAT and OD for 7 days
Abx if raised CRP/WCC
CXR