COPD Flashcards
What is chronic obstructive pulmonary disease (COPD)?
COPD is a progressive respiratory condition characterised by airflow limitation due to chronic bronchitis and/or emphysema.
What are the main pathological features of COPD?
Pathological features include chronic inflammation, mucus hypersecretion, airway narrowing, and destruction of alveoli (emphysema).
What are the common symptoms of COPD?
Symptoms include chronic cough, sputum production, dyspnoea, and wheezing.
What are the signs of COPD on clinical examination?
Signs include tachypnoea, prolonged expiration, wheezing, hyperinflated chest, and use of accessory muscles for breathing.
What are the risk factors for developing COPD?
Risk factors include smoking, long-term exposure to air pollution, occupational dust and chemicals, and alpha-1 antitrypsin deficiency.
What is the most common cause of COPD?
The most common cause is cigarette smoking.
What is the pathophysiology of COPD?
Chronic inflammation leads to airway remodelling, mucus hypersecretion, and destruction of alveolar walls, resulting in airflow limitation and impaired gas exchange.
How is COPD diagnosed?
Diagnosis is confirmed with spirometry showing a post-bronchodilator FEV1/FVC ratio <70%.
What are the spirometry findings in COPD?
Spirometry shows an obstructive pattern with a reduced FEV1/FVC ratio and a reduced FEV1.
What is the role of a chest X-ray in COPD?
Chest X-ray may show hyperinflation, flattened diaphragms, and increased retrosternal airspace, though it is not diagnostic.
What is the role of blood tests in COPD diagnosis?
Blood tests, such as alpha-1 antitrypsin levels, can identify genetic causes of COPD, while arterial blood gases assess hypoxaemia and hypercapnia.
What is the GOLD classification in COPD?
GOLD (Global Initiative for Chronic Obstructive Lung Disease) classifies COPD severity based on FEV1 (% predicted) and symptom burden.
What are the differential diagnoses for COPD?
Differential diagnoses include asthma, bronchiectasis, pulmonary fibrosis, and heart failure.
What is the initial management of stable COPD?
Management includes smoking cessation, bronchodilators, inhaled corticosteroids, pulmonary rehabilitation, and vaccination.
What bronchodilators are used in COPD?
Short-acting bronchodilators (e.g., salbutamol) and long-acting bronchodilators (e.g., tiotropium, salmeterol) are used to relieve symptoms.
What is the role of inhaled corticosteroids in COPD?
Inhaled corticosteroids reduce inflammation and exacerbations, particularly in patients with frequent exacerbations or asthmatic features.
What vaccinations are recommended for COPD patients?
Annual influenza vaccination and pneumococcal vaccination are recommended to prevent respiratory infections.
What lifestyle modifications are recommended for COPD patients?
Smoking cessation, regular physical activity, and maintaining a healthy diet are crucial.
What are the complications of COPD?
Complications include respiratory failure, pulmonary hypertension, cor pulmonale, and recurrent respiratory infections.
What is the management of an acute exacerbation of COPD?
Management includes nebulised bronchodilators, corticosteroids, antibiotics (if indicated), and oxygen therapy (target SpO2 88-92%).
What are the triggers for COPD exacerbations?
Triggers include respiratory infections, air pollution, and inadequate medication adherence.
What is the role of long-term oxygen therapy (LTOT) in COPD?
LTOT is used in patients with chronic hypoxaemia to improve survival and reduce complications such as pulmonary hypertension.
What is pulmonary rehabilitation?
Pulmonary rehabilitation is a programme of exercise, education, and support to improve quality of life and physical fitness in COPD patients.
What is the prognosis for COPD?
Prognosis depends on disease severity, with advanced COPD associated with significant morbidity and mortality.
What are the indications for referral to secondary care in COPD?
Indications include severe or rapidly progressing disease, frequent exacerbations, need for long-term oxygen therapy, or suspicion of alternative diagnoses.
