COPD Flashcards
What is chronic bronchitis?
Chronic or recurrent excessive mucus secretion in the bronchial tree
What is the diagnostic criteria for chronic bronchitis (symptom-based diagnosis)?
Coughing most days in a 3-month period in 2 consecutive years
What is the definition of emphysema?
An increase beyond the normal in the size of the air spaces distal to the terminal bronchiole accompanied by destruction of their walls and without obvious fibrosis
Although emphysema is a histological diagnosis, what imaging can show signs of emphysema?
CT scan of the chest
What is the main cause of emphysema?
Smoking
Apart from smoking, what can cause emphysema?
Exposure to coal dust
Other occupational exposures
What is the working definition of COPD?
- Airflow obstruction (FEV1/FVC<0.7)
- Airway and parenchymal damage
- Chronic inflammation due to smoking (not asthma)
- Characteristic symptoms eg breathlessness, cough, phlegm production (though patient may not compain of any symptoms)
What are the treatment options for patients with COPD? (8 points)
- Smoking cessation
- Vaccinations (flu and coronavirus)
- Pulmonary rehabilitation
- Inhaled therapy - LABA/LAMA/ICS
- Anti-inflammatory/antibiotic therapy
- Medication to cough up phlegm eg carbocisteine (thins phlegm to ease coughing)
- In select patients, long term oxygen therapy
- Treatments for other health problems (linked to smoking)
COPD predisposes death from flu
What are the problems associated with COPD? (8 points)
Smoking
Shortness of breath
Frequent exacerbations of symptoms (eg coughing of phlegm changes in colour and thickness)
Respiratory failure
Cor Pulmonale (extremely low oxygen level hence putting pressure on the RHS of the heart leading to right heart failure)
Abnormally low BMI
Chronic productive cough
Anxiety and depression
Definition of respiratory failure: PaO2 (partial pressure of oxygen aka amount of oxygen dissolved in the artery) < __ kPa ; insufficient to provide normal needs
8
COPD patients are typically extremely (slim/fat).
Slim
What type of respiratory failure is indicated low pO2 and high pCO2?
Type 2
What indicates type 1 respiratory failure?
Low pO2
In susceptible patients (eg COPD) who receive high flow oxygen treatments, the amount of pCO2 can increase in the blood and can make it acidic when dissolved. This is associated with an increased risk of ________.
Death
Long term oxygen treatment (LTOT) is indicated in patients with COPD, particularly:
- PaO2 <7.3kPa
- PaO2 <8kPa and one of secondary polycythaemia, nocturnal hypoxaemia (oxygen saturation of arterial blood [SaO2] less than 90% for more than 30% of the time), peripheral oedema, pulmonary hypertension
