COPD Flashcards
Gary Hank is a 65 year old male that presents with a 5-year history of worsening shortness of breath, chronic cough with sputum production and wheezing. He has a long history of smoking, having smoked 1 pack of cigarettes per day for over 40 years.
State your diagnosis and one important diagnosis to rule out
COPD and lung cancer
Describe this chest-x ray
- Barrel chest of COPD
- Blunted costo-phrenic angles
- Diaphragm is blunt
State some signs you would expect to see on examination
- Tachypneic
- Hyper-resonant percussion
- Cyanosis
- Reduced chest expansion
Describe the pathophysiology of COPD
COPD is characterised by irreversible obstruction of the airways.
It compromises both chronic bronchitis, which involves hypertrophy and hyperplasia of the mucus glands in the bronchi, and emphysema, which involves enlargement of air spaces and destruction of alveolar walls.
Explain what you would expect to see on a CT of bronchiectasis and why you see this sign?
Signet ring sign
Dilated bronchus with thickened, enhancing wall and a central area of low attenuation.
Due to mucous plugging, chronic inflammation and destruction of the bronchial wall
Describe what this histology specimen is showing
Emphysema
Destruction of the alveolar walls which results in bullae, thin alveolar walls
Loss of elastic fibres- pale, stretched-out structures
Inflammatory cells- neutrophils and macrophages
Name the structures of the conducting and respiratory portions on this model, state where the conducting becomes the respiratory portion.
How does nebulised salbutamol work in acute exacerbations of COPD?
Short acting beta 2 agonist
Causes the smooth muscle to relax and dilate the airways, which allows for improved airflow and easier breathing.
This effect is due to the activation of adenylate cyclase, which increases cAMP
It has anti-inflammatory properties as it inhibits the release of histamine and leukotrienes.
