COPD Flashcards
The COPD disease process affect the mechanical properties of the lung. What does this result in?
- Loss of elasticity
- Hyperinflation
- Increased sputum production
- Loss of alveolar gas exchange surface
What are COPD problems leading to respiratory failure?
Lung hyperinflation and/or fatigue
- Shallow ineffective breathing
- Reduced ventilation
- Incomplete lung emptying
Increased VQ mismatch
Decreased responsiveness to hypoxia
- Increased dead space
What is Chronic Obstructive Pulmonary Disease (COPD)?
- A common preventable & treatable disease
- Characterised by persistent air flow limitation
- Usually progressive (spans 20-50 years)
- Associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases
What does ‘COPD’ stand for?
Chronic Obstructive Pulmonary Disease
What (3) things is COPD an umbrella term for?
- Chronic Bronchitis
- Emphysema
- Chronic Severe Asthma
What are some typical co-morbidities for COPD?
- Ischaemic heart disease
- Cardiac failure
- Osteoporosis
- Diabetes metabolic syndrome
- Nomocytic anaemia
- Depression
What are the causes of COPD?
- Smoking
- Industrial pollutants
- Mining
- Bacteria infection
- Viral infection
- Wood, fire, biomass fuels
- Vehicle exhaust pollution
What is emphysema?
Permanent enlargement of the alveoli
- Destruction of alveolar walls
- Lungs lose their elasticity
- Walls of terminal bronchioles and alveoli are destroyed by inflammation
- Airway collapse
- Air trapping
- Enlarged alveoli sacs-dead space
Describe air trapping in emphysema.
- Bronchioles open on inspiration but
collapse on expiration - Air trapped within alveoli
- Hyperinflation-barrel chest
- Diaphragm flattens
- Ventilation capacity decreased
What does the excessive use of accessory muscles mean for patient’s with emphysema?
- Tire easily
- Lots of energy use
How does emphysema affect the heart?
- Alveolar walls disintegrate
- Increases resistanceinpulmonary circulation
- Right ventriclehas to work
harder - Enlarged right ventricle
- Cor pulmonale
What does emphysema co-exit with?
Chronic bronchitis
What is bronchitis?
An inflammation of the lining of the bronchial tubes
What is chronic bronchitis?
A cough that occurs every day with sputum production that lasts for at least 3 months, 2 years in a row.
What is a major cause of chronic bronchitis?
- Cigarette smoking
- Bronchial irritants
(usually inhaled repeatedly by the affected person)
Describe chronic bronchitis.
- The lining of the bronchial tubes repeatedly becomes irritated and inflamed, which can damage the airways and cause a build up of sticky mucus, making it difficult for air to move through the lungs.
- This leads to breathing difficulties that gradually get worse.
- The inflammation can also damage the cilia
- When the cilia don’t work properly, the airways often become a breeding ground for bacterial and viral infections.
-Infections typically trigger the initial irritation and swelling that lead to acute bronchitis.
What are symptoms of COPD?
- Cough
- Dyspnoea-difficult or laboured breathing
- Excessive sputum production
- Chest tightness or wheeze
- Oedema
- Heart failure
- Recurrent chest infections
- Hyperinflated lungs
- Fatigue
- Chest pain/discomfort
What should be done to diagnose COPD?
- Spirometry
- Chest x-ray
- Full blood count to identify anaemia or polycthaemia
- BMI
- Sputum culture
- Home peak flow measurements (to exclude asthma if doubt remains)
- Electrocardiogram (ECG)
- Echocardiogram
- CT thorax
- Serum alpha-1 antitrypsin
What is exacerbation of COPD?
An acute worsening of respiratory symptoms that result in additional therapy
What is mild exacerbation of COPD?
Treated with short acting bronchodilators (SABD) only
What is moderate exacerbation of COPD?
Treated with SABDs plus antibiotics and/or oral corticosteroids
What is severe exacerbation of COPD?
Patient requires hospitalisation or visits to the emergency department.
- Severe exacerbations may also be associated with acute respiratory failure
What are some symptoms of exacerbated COPD?
- Dyspnoea
- Fatigue
- Cold symptoms
- Sputum colour changes
- Sputum volume changes
- Cough
What are the symptoms of non-infective exacerbation of COPD?
- Increased dyspnoea
- Upper airway symptoms (e.g.:, colds and sore throats)
- Increased wheeze and chest tightness
- Fatigue and reduced ex tolerance
- Marked respiratory distress with dyspnoea + tachypnoea
- Possibly acute confusion, increased cyanosis, peripheral oedema
- Respiratory failure
