COPD

Question 1

Entities of COPD

Answer 1

Chronic bronchitis (>3months for 2 consecutive yrs)
and
Emphysema

Almost all pts are smokers

Question 2

CXR findings of emphysema

Answer 2

Permanantly dilated and destructed alveoli

1. Decreased broncho-vascular markings
2. Flattened diaphragm
3. Hyperinflation of lungs
4. Tubular elongated heart

Question 3

Emphysema without chronic bronchitis in young pt with abnormal liver function. What is the condition?

Answer 3

Alpha1 Antitrypsin deficiency
(L&L)

Question 4

Symptoms of COPD

Answer 4

Chronic cough
Decreased O2 sat

Smoker/high air pollution

Question 5

Diagnostic test for COPD

Answer 5

Spirometry/Lung function test
FEV1 FVC

Question 6

Acute exacerbation in COPD causation, investigations?

Answer 6

Due to virus»bacteria

Initial inv - ABG
Next - O2 sat

Question 7

Amount of O2 given in a COPD pt with low O2 saturation? Compare with asthma

Answer 7

2-4 L/min, higher O2 leads to respiratory centre depression
keep sat b/w 88-92%

6-8L in asthma

Question 8

Mx of Acute exacerbation in COPD

Answer 8

1. 2-4L/min of O2
2. Bronchodilators
   Salbutamol AND Ipratropium bromide(anticholinergic)
3. Steroids oral or IV
4. Antibiotics
   Amoxycillin/Amoxiclav

Question 9

Mx of COPD

Answer 9

SAMA/SABA (short acting muscarnic antagonist)
…
LAMA/LABA
…
LABA+LAMA
…
ICS+LABA+LAMA