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Patho Case Studies > COPD > Flashcards

COPD Flashcards

1
Q

What are the general risk factors for developing COPD?

A

Smoking, Chemicals, Environmental, Genetics, Alpha anti-trypsin

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2
Q

What are the risk factors for developing COPD specific to the case study?

A

Major one is Smoking (~10 a day for about 40 years not anymore). Environmental worked in social wellfare and had ‘muck’ dropping on her. Genetic mother, brother and sister all died from COPD.

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3
Q

What are the general signs and symptoms of COPD?

A

Barrel chest, blue tinged lips, chronic cough, finger clubbing, pursed lips when breathing, shortness of breath on exertion, use of accessory muscles when breathing, laboured breathing

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4
Q

What are the signs and symptoms of COPD specific to the case study?

A

Breathlessness/SOB with exertion, Dyspnoea/laboured breathing, Pursed lip breathing, Barrel shaped chest, increased expiratory effort, use of accessory muscles, slightly bluish/purple tinged lips.

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5
Q

What is the general pathophysiology of COPD.

A

Chronic inflammation in alveoli
- Increased oxidative stress
and
- Increased proteases
Leading to:
Tissue breakdown
- Alveolar walls
- Pulmonary capillary walls
- Elastic fibres

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6
Q

What are the complications that arise from COPD specific to the case study?

A

Decreased appetite therefore weightloss (2kg) emaciation. Occasionally she gets ankle swelling/oedema secondary to right sided heart condition which is a complication of her COPD. Cyanosis (purple/blue tinged lips). Episodes of acute respiratory failure.

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7
Q

What is Emphysema?

A
  • loss/destruction of alveoli & associated capillaries
  • Loss of elastin
  • Enlarged air spaces & air trapping
  • Decreased surface area of alveoli => decreased gas exchange
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8
Q

What is Bronchitis COPD?

A
  • Bronchial inflammation & oedema
  • Increased mucous production
  • Decreased cilia action
  • Increased airway resistance => decreased gas exchange
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9
Q

What can enlarged airspaces lead to?

A

> Air retention
Hyperinflation
-> affects on thoracic cavity
-> Changes in lung volume (^ residual volume)
=> Increased work of breathing

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10
Q

What can reduced alveolar surface area lead to?

A
  • Decreased gas exchange
  • Hypoxia (Decreased O2 in tissue) - Hypercapnia (Increased CO2)
  • Acidosis, Pulmonary hypertension
  • Respiratory failure
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11
Q

What type of COPD does the case study patient have?

A

Emphysema and Chronic bronchitis

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12
Q

Other Complications of COPD.

A

Respiratory Acidosis
Metabolic Acidosis
Cyanosis
Tissue wasting/emaciation
Pulmonary hypertension & cor pulmonale
Respiratory failure

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13
Q

What are the 2 expected lab tests for COPD on admission?

A

Blood gases and pH
Sputum Sample

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14
Q

What are the expected investigations for COPD on admission?

A

Chest x-ray
Pulmonary function tests
ECG

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15
Q

What is the purpose of the arterial blood gas test?

A

Checks oxygenation status and acid balance

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16
Q

What is the purpose of the pulse oximetry test?

A

Estimates O2 content in arterial blood using light

17
Q

What is the purpose of the Peak expiratory flow (PEF) test?

A

Measures how quickly you can exhale.

18
Q

What is the purpose of the body plethysmography test?

A

Measures thoracic volume and airway resistance.

19
Q

What is the purpose of the forced expiratory volume (FEV) test?

A

Tests how much air you can exhale in 1 second.

20
Q

What is the purpose of the diffusing capicity test?

A

Tests oxygen transfer from the alveoli to circulation.

21
Q

What is the purpose of the sputum culture test?

A

Used to diagnose bacterial lung infection.

22
Q

What is often revealed in a COPD patients blood tests?

A

Increased hemoglobin level with an increased red blood cell count and a raised hematocrit.

23
Q

What does raised hemoglobin level with increased red blood cell count and a raised hematocrit indicate the body is doing?

A

compensating for lower PO2 by increasing the O2 carrying capacity of the blood

24
Q

What does raised PCO2 result in?

A

Chronic respiratory acidosis

25
Q

How does CO2 become a central nervous system depressent?

A

This can happen if the patient goes into acute respiratory failure the arterial PCO2 can be so high that rather being a stimulant CO2 becomes a depressent.

26
Q

What is a potential complication of O2 administration to a patient who is experiencing the CO2 nervous system depression?

A

It may actually cause the patient to cease breathing as the hypoxic respiratory drive is removed.

27
Q

What is spirometry?

A

The most common pulmonary function test performed routinely. It can assess aspects of lung function by measuring airflow and the corresponding changes in lung volumes.

28
Q

What does spirometry record?

A

Inspiratory and expiratory lung volumes as well as how fast a patient can inhale/exhale.

29
Q

What is a beta-agonist?

A

Drug that binds to beta2 adrenergic receptors on bronchiole smooth muscle, stimulating bronchodilation by acting on the actin and myosin.

30
Q

What is an anticholinergic?

A

A drug that blocks muscarinic acetylcholine receptors on bronchiole smooth muscle, preventing bronchoconstriction and therefore allowing bronchodilation.

31
Q

What is a corticosteroid?

A

A drug that has anti-inflammatory agents used to decrease the inflammatory response.

32
Q

What is oxygen therapy used for?

A

Low-level oxygen therapy may be used to maintain adequate oxygen saturation

33
Q

What medications are specific to this case study?

A

Salbutamol (ventolin)
Seretide
Spiriva
Domicilliary oxygen therapy

34
Q

What is salbutamol (ventolin)?

A

This is a short acting beta-agonist bronchodilator

35
Q

What is seretide?

A

A combined medication that includes a long acting beta-agonist bronchodilator & corticosteroid

Patho Case Studies (4 decks)

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