COPD

Question 1

what are the hallmark symptoms of COPD

Answer 1

Chronic cough (persistent, often productive)
Progressive dyspnea (shortness of breath with activity, then at rest)
Sputum production (thick, excessive mucus)
Wheezing & chest tightness
Fatigue, weight loss, anorexia

Question 2

what are the advanced signs?

Answer 2

Barrel chest (due to hyperinflation)
Use of accessory muscles for breathing
Pursed-lip breathing (to control airflow)
Clubbing & cyanosis (late-stage hypoxemia)
Tripod positioning (leaning forward to breathe)

Question 3

what are the causes?

Answer 3

Cigarette smoking (80-90% of cases)
Other Causes:
Air pollution, occupational dust/chemicals
Genetic: Alpha-1 antitrypsin deficiency (AATD)
Recurrent respiratory infections

Question 4

what does PFE show?

Answer 4

FEV1/FVC < 70% confirms airflow obstruction
Measures disease severity

Question 5

what does ABG show?

Answer 5

Hypoxemia (PaO₂ < 60 mmHg)
Hypercapnia (PaCO₂ > 45 mmHg)
Respiratory acidosis (low pH, high CO₂) in advanced COPD

Question 6

what does chest x ray show?

Answer 6

Flattened diaphragm (hyperinflation)
Hyperinflated lungs
Bullae/blebs (emphysema)

Question 7

what are the first line medications given?

Answer 7

Long-acting muscarinic antagonists (LAMAs) → Tiotropium
Long-acting β₂-agonists (LABAs) → Salmeterol, Formoterol
Combination LAMA/LABA for severe disease

Question 8

what are the other medications given?

Answer 8

Short-acting bronchodilators (SABAs) → Albuterol, Ipratropium (for acute symptoms)
Inhaled corticosteroids (ICS) → Fluticasone, Budesonide (for frequent exacerbations) Theophylline (used rarely due to side effects)

Question 9

what is the goal of oxygen therapy for COPD?

Answer 9

Maintain SpO₂ > 90% to prevent pulmonary hypertension
Caution: High O₂ can blunt respiratory drive, leading to CO₂ retention → Respiratory failure

Question 10

what does pulmonary rehabilitation do for COPD?

Answer 10

Exercise training, education, breathing exercises
Improves dyspnea, quality of life, and functional capacity

Question 11

what are the breathing techniques for COPD?

Answer 11

Pursed-lip breathing → Slows exhalation, prevents airway collapse
Diaphragmatic breathing → Strengthens breathing muscles

Question 12

what are the dietary considerations for COPD

Answer 12

High-protein, high-calorie diet (small, frequent meals)
Avoid gas-producing foods (to prevent bloating & diaphragm compression)

Question 13

what does Lung Volume Reduction Surgery (LVRS) do

Answer 13

Removes hyperinflated lung tissue → Improves breathing mechanics

Question 14

what does bullectomy do?

Answer 14

Removes large bullae in emphysema

Question 15

what does lung transplant do?

Answer 15

For end-stage COPD with severe hypoxia/hypercapnia

Question 16

what are the signs of COPD exacerbations

Answer 16

increased dyspnea
Increased sputum production
Change in sputum color (yellow/green → possible infection)
Worsening fatigue & activity intolerance

Question 17

when do you seek emergency care?

Answer 17

Severe dyspnea, cyanosis, confusion
Worsening respiratory distress despite bronchodilators
Signs of right-sided heart failure (peripheral edema, JVD, hepatomegaly)

Question 18

what should the Pt do?

Answer 18

Smoking Cessation (most effective way to slow disease progression)
Pulmonary rehab & breathing techniques
Annual flu & pneumococcal vaccines (reduce infection risk)
Avoid respiratory irritants (dust, fumes, extreme temperatures)
Monitor for early signs of infection/exacerbation