COPD

Question 1

What is COPD?

Answer 1

Airflow obstruction
Progressive disease
Not fully reversible

Question 2

What are symptoms of COPD?

Answer 2

Breathlessness, Wheeze, Cough

Chronic inflammation in the airways leading to chronic bronchitis - can lead to cough and recurrent chest infection

Question 3

What systemic effects of COPD?

Answer 3

Loss of muscle mass - due to metabolic disturbances
Wight loss
Cardiac disease
Depression, anxiety

Question 4

How do you manage COPD non-pharmalogically

Answer 4

Smoking cessation
Vaccinations
Pulmonary rehab
Nutritional assessment
Psych support

Question 5

What does COPD rehab entail?

Answer 5

Six week course of rehab supported by allied health professionals

Includes exercise prescription
Eduction
Nutritional support
Psych support
Diagnosis and management of co-morbidities
Management strategies

Question 6

What vaccinations should COPD patients be offered?

Answer 6

Pneumococcal vaccine - once in every 5 years
Flu vaccine

Question 7

What are the benefits of inhaled therapy?

Answer 7

Relive symptoms
Prevent exacerbations
Improve quality of life

Question 8

What groups of inhalers are avaible?

Answer 8

Short acting - up to 4 hours
SBA, SAMA

Long acting
LAMA
LABA

High dose corticosteroids (ICS) and LABA

Question 9

COPD Value pyramid?

Answer 9

Search it up - discusses the benefit and the cost of each available treatment

Question 10

What’s the criteria for being offered Long Term Oxygen?

Answer 10

PaO2 <7.3kPa
Or

PaO2 7.3 - 8kPa if

Polycythaemia
Nocturnal hypoxia
Peripheral oedema
Pulmonary hypertension

Question 11

What are signs of COPD exacerbation?

Answer 11

Increasing brethlessness
Cough
Sputum volume
Sputum purulence
Wheeze
Chest tightness

Question 12

AECOPD - Primary Care management?

Answer 12

Short Acting bronchodilators (Nebulisers if enhancers don’t work)
Steroids
Antibiotic
Consider hospital treatment if unwell i.e hypertension low <92 SPO2

Question 13

Investigations for COPD?

Answer 13

Full blood count
Biochem and hluscose
Theophylline conce
Arterial blood gas
ECG
Chest x-ray
Blood cultures in febrile patients
Sputum microscopy, culture and sensitivity

Question 14

How to we manage COPD on ward?

Answer 14

O2 stats 88-92%
Nebulised bronchodilator
Corticosteroids
Antibiotics - ideally orally
Assess for evidence of resp failure - clinical and Arterial blood gas

Question 15

If AECOPD are experiencing acute resp failure…

Answer 15

Give them non-invasive ventilation

Question 16

What app would you advise for self manage for COPD

Answer 16

My COPD

Question 17

Management of palliative care COPD patients

Answer 17

Manage Breathlessness and dysfunctional breathing
- pharmacological support
Palliative care referral
Morphine

Anticipatory care plan
- hospital admission if they want?
Ceiling of treatment - ward based, HDU, Ventiltion
- DNACPR