COPD

Answer 1

Caused by the body’s response to inhaled toxins.

Question 2

Pathophyisology of COPD

Answer 2

Long term inflammation of the bronchi

Question 3

common symptoms of copd

Answer 3

1. Dyspnoea
2. wheezing
3. lack of energy
4. frequent respiratory infections
5. chest tightness
6. excess mucous
7. chronic cough - may produce mucus
8. unintended weight loss in later stages

Question 4

Epidemiology of COPD

Answer 4

1. More common in males (uk)
2. usually diagnose mid 50s (uk)
3. 3 million people affected worldwide (uk)
4. Higher rates found with those with low socioeconomic status
5. associated with co-morbitities: cardiovascular disease, lung cancer, depression, anxiety

Question 5

Aetiology of COPD

Causes

Answer 5

1. Air pollution
2. Smoking + passive smoke
3. Asthma
4. Chronic bronchitis
5. Chemical exposure
6. Age 40+
7. AAT deficiency

Question 6

COPD should be considered in patients who are:

Answer 6

1. 35+
2. (ex) smokers
3. symptoms of: exertional breathlessness
4. chronic cough
5. sputum production
6. frequent winter bronchitis or wheeze
7. Exposure to toxins - employment
8. family history of COPD
9. Spirometry tests

Question 7

What is the purpose of spirometry in COPD

Answer 7

1. Grades severity
2. Reversibility testing: <200mL difference pre and post bronchodilator

Question 8

What is FVC and FEV1 and how are they used

Answer 8

FVC (Forced vital capacity)
* Total amount of air blown out after taking a deep breath in and emptying lungs
FVC1
* The amount of air blown out in one second.

FEV1:FVC ration
<70% = obstructive lung disease

Question 9

COPD severity classes (GOLD)

Answer 9

Gold:
1. Mild ≥ 80%
2. Moderate 50 - 79%
3. Severe 30 - 49%
4. Very severe <30%

Question 10

Which two grading systems can we use to classify COPD

Answer 10

1. GOLD
2. mMRC dyspnea scale
3. CAT tool

Question 11

mMRC dyspnea scale

Answer 11

mMRC:
0. i only become breathless with strenous excersise
1. I become short of breath when hurrying on the level or walking up a slight hill
2. I walk slower than most people the same afe on the level because of breathlessness, or I have to stop for breath when walking at my own pace on the level
3. I stop for breath after walking approximately 100m or after a few minutes on the level
4. I am too breathless to leave the house or breathless when dressing or undressing

Question 12

What is included in a full COPD assesment?

Answer 12

• Degree of obstruction – spirometry results
• Current nature and magnitude of patient’s symptoms
• mMRC Score, CAT Assessment.
• History of moderate and severe exacerbations
• Presence of co-morbidities