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Clinical lectures: Yr2 > COPD > Flashcards

COPD Flashcards

1
Q

What is Chronic Obstructive Pulmonary Disease (COPD)?

A

Chronic disorders that restrict airflow due to damage to the airways or lung parenchyma, causing respiratory symptoms and dyspnoea on exertion.

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2
Q

What are the most common types of COPD?

A
  • Chronic bronchitis
  • Emphysema
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3
Q

What characterizes emphysema?

A

Permanent rupture of the alveoli distal to the terminal bronchioles, causing them to merge into larger air spaces.

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4
Q

At what age does COPD typically onset?

A

In the 60s or later.

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5
Q

What is the major risk factor for COPD?

A

Cigarette smoking.

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6
Q

List some environmental risk factors for COPD.

A
  • Exposure to biomass fuel
  • Industrial dust
  • Chemicals
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7
Q

What genetic risk factor is associated with COPD?

A

a1-antitrypsin deficiency.

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8
Q

What role does a1-antitrypsin play in the lungs?

A

It protects tissues from enzymes such as elastase.

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9
Q

What is the hallmark of COPD pathophysiology?

A

Progressive chronic inflammation affecting airways, parenchyma, and alveoli.

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10
Q

What happens to inflammation in COPD after stopping risk factors?

A

It persists even after stopping risk factors.

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11
Q

What are some changes that occur in the airways due to COPD?

A
  • Narrowing and remodelling of airways
  • Increased number of goblet cells
  • Enlargement of mucus-secreting glands
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12
Q

What cells are core to the inflammation process in COPD?

A
  • Activated macrophages
  • Neutrophils
  • Leukocytes
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13
Q

What factors amplify the effects of chronic inflammation in COPD?

A

Oxidative stress and an excess of proteases.

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14
Q

What causes the loss of alveolar integrity in emphysema?

A

Elastin breakdown.

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15
Q

What leads to excessive mucus secretion in COPD?

A

Ciliary dysfunction and increased goblet cell size and number.

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16
Q

What condition does expiratory flow limitation promote in COPD patients?

A

Hyperinflation.

17
Q

What is a consequence of hyperinflation and destruction of lung parenchyma in COPD?

A

Hypoxia, particularly during activity.

18
Q

What happens to vascular smooth muscle due to progressive hypoxia in COPD?

A

Thickening of vascular smooth muscle leading to pulmonary hypertension.

19
Q

What may reduced gas transfer in COPD lead to?

A

Hypercapnia.

20
Q

What is the hallmark feature of COPD?

A

The hallmark feature is progressive and persistent dyspnoea that is worst on exertion.

21
Q

What are common respiratory issues in COPD patients?

A

Patients will have frequent lower respiratory tract infections.

22
Q

How does chronic bronchitis present?

A

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.

23
Q

What are the presentations of emphysema?

A

Emphysema causes hypoxemia, acidosis (low blood pH), and hypercarbia/hypercapnia (increased serum bicarbonate/carbon dioxide levels): Type 2 respiratory failure.

Type 1: Hypoxemia only.

24
Q

What are symptoms of hypoxemia?

A

Symptoms include cyanosis (blue skin), headaches, and tachycardia.

25
Q

What are symptoms of hypercapnia?

A

Symptoms include dyspnea, fatigue, confusion, inability to focus, disorientation, and hyperinflation of the chest.

26
Q

What are the effects of severe emphysema?

A

Severe emphysema causes weight loss and malnourishment.

27
Q

Does COPD cause clubbing?

A

No, COPD does not cause clubbing.

28
Q

What are common findings during COPD investigations?

A

Spirometry confirms diagnosis. Signs may include cyanosis, cachexia, chest hyperinflation, and wheeze/crackles on auscultation.

29
Q

What should be considered if a COPD patient is younger than 40?

A

Consider alpha-1-antitrypsin deficiency if the person is younger than 40 years of age or has a family history.

30
Q

What tools are used to assess dyspnoea in COPD?

A

Assess dyspnoea with the Medical Research Council (MRC) dyspnoea scale and the COPD Assessment test (CAT).

31
Q

What investigations are used for COPD?

A

Investigations include chest x-ray and FBC to rule out anaemia and secondary polycythemia.

32
Q

What is the role of long-term oxygen therapy in COPD management?

A

Long-term oxygen therapy (LTOT) can improve survival in people with stable COPD and chronic hypoxia.

33
Q

What are key management strategies for COPD?

A

Management includes smoking cessation, keeping vaccinations up to date, pulmonary rehabilitation, and nutritional support including vitamin D.

34
Q

What are the treatment groups for COPD?

A

Group A: bronchodilator (e.g., SABA); Group B: LABA and LAMA; Group E: LABA and LAMA, maybe ICS.

Clinical lectures: Yr2 (41 decks)

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