COPD Flashcards
What is Chronic Obstructive Pulmonary Disease (COPD)?
Chronic disorders that restrict airflow due to damage to the airways or lung parenchyma, causing respiratory symptoms and dyspnoea on exertion.
What are the most common types of COPD?
- Chronic bronchitis
- Emphysema
What characterizes emphysema?
Permanent rupture of the alveoli distal to the terminal bronchioles, causing them to merge into larger air spaces.
At what age does COPD typically onset?
In the 60s or later.
What is the major risk factor for COPD?
Cigarette smoking.
List some environmental risk factors for COPD.
- Exposure to biomass fuel
- Industrial dust
- Chemicals
What genetic risk factor is associated with COPD?
a1-antitrypsin deficiency.
What role does a1-antitrypsin play in the lungs?
It protects tissues from enzymes such as elastase.
What is the hallmark of COPD pathophysiology?
Progressive chronic inflammation affecting airways, parenchyma, and alveoli.
What happens to inflammation in COPD after stopping risk factors?
It persists even after stopping risk factors.
What are some changes that occur in the airways due to COPD?
- Narrowing and remodelling of airways
- Increased number of goblet cells
- Enlargement of mucus-secreting glands
What cells are core to the inflammation process in COPD?
- Activated macrophages
- Neutrophils
- Leukocytes
What factors amplify the effects of chronic inflammation in COPD?
Oxidative stress and an excess of proteases.
What causes the loss of alveolar integrity in emphysema?
Elastin breakdown.
What leads to excessive mucus secretion in COPD?
Ciliary dysfunction and increased goblet cell size and number.
What condition does expiratory flow limitation promote in COPD patients?
Hyperinflation.
What is a consequence of hyperinflation and destruction of lung parenchyma in COPD?
Hypoxia, particularly during activity.
What happens to vascular smooth muscle due to progressive hypoxia in COPD?
Thickening of vascular smooth muscle leading to pulmonary hypertension.
What may reduced gas transfer in COPD lead to?
Hypercapnia.
What is the hallmark feature of COPD?
The hallmark feature is progressive and persistent dyspnoea that is worst on exertion.
What are common respiratory issues in COPD patients?
Patients will have frequent lower respiratory tract infections.
How does chronic bronchitis present?
Chronic bronchitis presents with recurrent, productive cough with increased yellow/green sputum volume, and wheezing/whistling sound when breathing.
Haemoptysis can occur more commonly during flare-ups.
What are the presentations of emphysema?
Emphysema causes hypoxemia, acidosis (low blood pH), and hypercarbia/hypercapnia (increased serum bicarbonate/carbon dioxide levels): Type 2 respiratory failure.
Type 1: Hypoxemia only.
What are symptoms of hypoxemia?
Symptoms include cyanosis (blue skin), headaches, and tachycardia.
What are symptoms of hypercapnia?
Symptoms include dyspnea, fatigue, confusion, inability to focus, disorientation, and hyperinflation of the chest.
What are the effects of severe emphysema?
Severe emphysema causes weight loss and malnourishment.
Does COPD cause clubbing?
No, COPD does not cause clubbing.
What are common findings during COPD investigations?
Spirometry confirms diagnosis. Signs may include cyanosis, cachexia, chest hyperinflation, and wheeze/crackles on auscultation.
What should be considered if a COPD patient is younger than 40?
Consider alpha-1-antitrypsin deficiency if the person is younger than 40 years of age or has a family history.
What tools are used to assess dyspnoea in COPD?
Assess dyspnoea with the Medical Research Council (MRC) dyspnoea scale and the COPD Assessment test (CAT).
What investigations are used for COPD?
Investigations include chest x-ray and FBC to rule out anaemia and secondary polycythemia.
What is the role of long-term oxygen therapy in COPD management?
Long-term oxygen therapy (LTOT) can improve survival in people with stable COPD and chronic hypoxia.
What are key management strategies for COPD?
Management includes smoking cessation, keeping vaccinations up to date, pulmonary rehabilitation, and nutritional support including vitamin D.
What are the treatment groups for COPD?
Group A: bronchodilator (e.g., SABA); Group B: LABA and LAMA; Group E: LABA and LAMA, maybe ICS.
