COPD Flashcards
Components of COPD
Chronic bronchitis
Emphysema
Whats chronic bronchitis
Neutrophilic inflammation causing scarring & fibrosis from cigarette smoke
Hypertrophy mucus secreting glands
Hyperplasia of goblet cells
What is emphysema
Inflammation causing loss of elastic recoil
Neutrophils release proteases that break down elastin in alveolar walls
Aetiology of COPD
Smokers
>40 years
Genetics - alpha-1 antitrypsin deficiency = failure to break down neutrophilic elastase
Clinical presentations of COPD
Chronic cough
Sputum production
Progressive dyspnoea
Regular exacerbations
Wheezing - bronchitis
Reduced air sounds - empysema
Investigations of COPD
Clinical exam & spirometry
Spirometry = obstructive pattern (FEV1/FVC <70%)
Diffusion capacity of carbon monoxide (DLCO) lowered = emphysema
Management long term
Smoking cessation
Vaccination - pneumococcal & flu
Active lifestyle - Pulmonary rehab
Manage comorbidities
Self education
Management Pharmacological
SAMA - Short acting muscarinic antagonist
SABA - Short acting bronchodilator agonist
LAMA- Long acting muscarinic antagonist
LABA - Long acting bronchodilator agonist
ICS - inhaled corticosteroids
Managing Acute exacerbation
Increase SABA
Prescribe steroids
Antibiotics if necessary
What is COPD
Lung disease characterised by airway obsturction due to inflammation of small airways
What is hypercapnic resp failure , how is it managed
Type 2 resp failure - low O2 and high CO2 & HCO3
Non-invasive ventilation
what oxygen stats should be aimed for with COPD
88-92%
