COPD Flashcards
Definition COPD
Preventable and treatable dx characterized by persistent airflow limitation usually progressive and associated with enhanced chronic inflammatory response in the airways and lungs after exposure to noxious particles or gases
Diagnosis related to COPD
Chronic bronchitis
Emphysema
What is chronic bronchitis?
Cough and sputum for at least three consecutive months in each of two consecutive years
What is emphysema?
Abnormal permanent enlargement of the airspaces distal to the terminal bronchioles with destruction of the walls and without obvious fibrosis
Co morbid conditions associated with COPD
Cardiovascular disease, cerebrovasculardisease
metabolic syndrome
osteoporosis
depression
lung cancer
Risk factors of COPD
Smoking Tobacco
Occupational exposure ( Coal dust exposure in biomass fuels, silica, cadmium)
Indoor air pollution in developing cou
Low birth weight
Lung growth problems
Infection like persistent adenovirus, HIV
Low socioeconomic status
Cannabis smoking
Genetics alpha, one antitrypsin deficiency
Airway hyperreactivity
Genetic disease linked to COPD
Alpha 1Antitrypsin deficiency
Pathophysiology of COPD
Increased sputum like in chronic bronchitis -> mucus secreting glands enlargement and goblet cells increase with inflammatory cell infiltrate
Pulmonary vascular remodeling -> impaired cardiac function
Loss of elastic tissue, inflammation and fibrosis in airway wall ->airway closure , gas trapping, dynamic hyperinflation -> changes in pulmonary and chest wall compliance
Destruction of alveoli due to action of proteases and oxidants -> emphysema
Emphysema classification
centriacinar
panacinar
paraseptal
COPD clinical features
Patients over 40 years
cough with sputum
Hemoptysis possible
Breathlessness
morning, headaches if hypercapnia
Edema in advance dx
Quiet breath sounds
crackles

Beating edema,
fatigue, anorexia, and weight loss when severe
To classical phenotypes in clinical features of COPD
Pink puffer
Blue bloater
COPD investigation
Chest x-ray for differential
Blood counts to exclude anemia
Alpha-1 anti-trip assay
Spirometry with a ratio of less than 70% post bronchodilator
Helium dilution technique for hyper inflation assessments
Body plethysmography for lung volume in severe cases
Exercise tests for prognosis
Pulse oximetry for oxygen assessments
COPD assessment tests, COPD control questionnaire
St. George respiratory questionnaire
Management of COPD
Smoking cessation
Non-smoking cooking devices, or alternative fuels
Bronchodilators, inhaled, short, acting if mild dx and long acting when moderate or severe
Combined inhaled c glucocorticoids and bronchodilators
Oral glucocorticoids for exacerbations
 Pulmonary rehabilitation through exercise
Oxygen therapy surgical intervention with you like to me 
