COPD Flashcards
What is COPD characterised by?
By airflow obstruction.
Progressive not fully reversible - due to combination of airway disease and parenchymal damage.
Treatable not curable.
Caused by smoking.
What is an example of an airway disease?
Obstructive bronchiolitis.
What predominantly causes COPD?
Smoking
What are exacerbations?
Rapid and sustained worsening of symptoms beyond normal day to day variations.
How is airflow obstruction/limitation measured?
Spirometry
What is FEV1?
Forced expiratory volume.
- Maximum amount of air which can be forcibly blown out of the lungs in one second.
What is FVC?
Forced vital capacity.
- Amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible.
What is the ratio of FEV1/FVC indicative of?
Airflow obstruction.
For diagnosis of COPD: FEV1/FVC = less than 0.7.
Describe chronic bronchitis.
Term referring to cough and sputum production for at least 3 months in each of 2 consecutive years.
Describe emphysema.
Refers to destruction of gaseous exchange surfaces of lungs - alveoli.
What are two very common mental co-morbidities of COPD and why do these occur?
Depression and anxiety.
Due to progressive breathlessness - leads to mobility issues and patient becoming housebound. Appears to be a disability and impairs quality of life.
What are the risk factors of smoking in terms of risk of COPD?
Higher prevalence of respiratory symptoms and lung function abnormalities.
Greater annual decline in FEV1.
Greater mortality rate.
What would you suggest a smoker to do when diagnosed with COPD?
Smoking cessation
-best way to delay progression of COPD at all stages of disease.
What is the consequence in continuing smoking for a COPD patient?
Patients who continue to smoke will see a greater decline in FEV1 and they will lose lung function at a more rapid rate. Loss of function cannot be regained.
List risk factors other than smoking which can increase risk of developing COPD?
Genetics, age, gender, lung development, exposure to particles, socioeconomic status, asthma/bronchial hyperactivity.
How does genetics play a part in developing COPD?
Results from interaction between genes and environment.
Usually is a severe hereditary deficiency of Alpha-1 Antitrypsin = circulating inhibitor of serine proteases.
How does smoking during pregnancy result in COPD in the child’s later life?
Mother smoking while pregnant can result in reduced lung function later in life or childhood.
How does air pollution cause COPD?
Air pollution has huge impact on lung maturation and development and can be harmful to individuals with an existing lung condition.
How does socioeconomic status cause COPD?
Poverty increases risks – due to crowded households, lack of ventilation, indoor/outdoor pollution, poor nutrition, exposure to fumes, infections
What is lung parenchyma?
Functional lung tissue.
How does chronic inflammation result in pathological changes so the airways, lung parenchyma and pulmonary vasculature of blood vessels?
Chronic inflammation increases production of inflammatory cells. This results in structural changes - result of repeated injury and repair.
How does a COPD affected lung tissue look compared to healthy lung tissue?
Narrowing of airways and bronchioles and reduction in surfaces for gas exchange and absorption.
Define pathogenesis.
The manner of development of disease.
What physiological process causes phlegmy cough/ chronic productive cough?
Mucus hypersecretion.
What does ciliary dysfunction cause?
Results in abnormal mucocilliary clearance and difficulty in expectorating/coughing up phlegm.