COPD Flashcards
what is copd?
persistent airflow obstruction with enhanced chronic inflammation
symptoms of COPD?
SOB - persistent and worse with exercise
chronic cough
sputum
2 types of copd?
chronic bronchitis
emphysema
difference between the two classifications?
in emphysema alveolar walls are destructed where in bronchitis bronchioles clogged with mucus and lose shape
what is copd caused by?
predominantly by smoking and not fully reversible - stable and progressive
what happens when exposed to risk factors?
neutrophils and macrophages accumulate in alveoli which release granules containing elastase and MMP causing damage and tissue destruction
what would a deficiency of alpha 1 anti-trypsin cause?
deficiency can cause an imbalance between destructive and protective effects causing depletion of lungs defence
what is defined as an exacerbation of copd?
worsening of symptoms beyond day to day normal variation leading to a change in medication
most common causes of copd exacerbation?
viral upper respiratory tract infections
infection of tracheobronchial tree
what is needed for diagnosis of COPD?
evidence of symptoms - SOB, cough, sputum
exposure to risk factor - tobacco, pollution
spirometry result
when should a spirometry be performed?
after administration of adequate dose of short acting bronchodilator
what spirometry value confirms airflow obstruction?
FEV1/FVC ratio of less than 0.7 or 70%
what would be present in an asthmatic patient compared to copd?
FEV1 and FEV1/FVC ratio return to normal with drug therapy
very large FEV1 response to bronchodilators or prednisolone for 2 weeks
serial peak flow measurements showing 20% or greater day to day variability
key points of therapeutic options to treat copd?
smoking cessation
regular physical activity
appropriate pharmacologic therapy
influenza and pneumococcal vaccines offered
first choice for treating copd with intermittent symptoms?
short acting bronchodilators
- ipratropium (anticholinergic) SAMA
- salbutamol (beta antagonist) SABA
