Copd

Question 1

Def

Answer 1

Chronic obstructive pulmonary desease is defined as desease characterised by airflow limitations that is not fully reversible

Heterogeneous lung condition
Airflow limitations
Airway limitations
Airway obstruction
Irreversible
Chronic inflammatory response

Question 2

Types

Answer 2

Emphysema
Chronic bronchitis

Question 3

Etiology

Answer 3

Tobaco smoking
Toxic inhalation
Alpha1 antitrypsin deficiency
Occupational exposure (eg:coal, cement cotton)
Asthma leads air limitations leads to copd

Question 4

Signs and symptoms

Answer 4

Shortness of breath
Chronic cough
Wheezing
Dyspnea
Chest discomfort
Chest tightness

Question 5

Emphysema

Answer 5

★Irreversible degenerative condition
★Focal destruction to airspace from distal to terminal bronchioles
★lose of elastic recoil
★hyper expanded lung
★aiflow limitations
★increased residual volume
★increasednTLC
Flattening diaphragm
Increased lung volume
Enlarged left pulmonary artery

Question 6

Types

Answer 6

Centriacinarnemphysema
Panaacinar emphysema
Distal emphysema
Irregular emphysema

Question 7

Diagonosis

Answer 7

H/o patient
Physical examination
Spirometery
Post bronchodialator fev1/fvc <70 confirms persistent airflow limitations

Copd severity
Mild fevi>80
Moderate 50%<fev1<80%
Severe30-50
Very sever <30

Chest xray
Abg analysis
DLCO
Ios
Sputum culture
Ct scan cbg

Question 8

Pathophysiology

Answer 8

Toxic inhalation
Airway inflammation
Increased mucus secreating gland
Decreased ciliary function
Bronchial wall thickened and lumen narrowed and mucus plug in airway
Increased protease activity duento alpha 1 antitrypsin
Decreased elastin in alveoli
Narrowed airways and destruction of lung parenchyma
Pulmovasculature changes thickening vessel collagene vessel
Destruction of capillary beds
Chronic cough and sputum production infection

Question 9

Management

Answer 9

★02 therapy (02 saturation should be 94-98% or atleast 92%

★bronchidialator therapy
Saba first line treatment
Fev1>50 %-laba eg salmetrol tiotropium
Fev1<50%laba +inhaled corticosteroid or lama long acting muscuranic antagonist

★mucolytics

★cor pulmonale-long term 02 therapy,loop diuretic for edema ace inhibitors and calcium channel blockers

★inhaled steroids

★niv criteria
Ph<7.20 NIV is strongly advised and advised intubation
Ph<7.30 NIV strongly advised
Ph<7.35
Rr>25
Paco2>60 NIV is advised

★invasive ventilation
If patient is <7.20 and low gcs
★Pulmonary rehabilitation
★Surgery lvrs

Question 10

Chronic bronchitis

Answer 10

Chronic bronchitis is defined as persistent cough with sputum production for atleast 3 months in atleast 2 consecutive years