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Respiratory > COPD > Flashcards

COPD Flashcards

0
Q

What are the 3 most significant features of pink puffers?

A

Increased alveolar ventilation
Normal O2
Normal/low CO2

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1
Q

Which COPD condition are ‘pink puffers’ associated with?

A

Emphysema

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2
Q

What kind of respiratory failure can pink puffers experience?

A

Type 1

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3
Q

Which COPD condition are blue bloaters associated with?

A

Chronic bronchitis

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4
Q

What are the 3 most signif features of blue bloaters?

A

Decreased alveolar ventilation
Decreased PaO2
Increased CO2

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5
Q

What is a major complication of blue bloaters (but not pink puffers)?

A

Cor Pulmonale

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6
Q

Describe the process by which Cor Pulmonale can develop in COPD.

A

COPD ➡️ pulmonary hypertension (due to: capillary bed damage and hypoxia causing local vasoconstriction as a protection mechanism to divert blood to well ventilated areas) ➡️ backlog of blood ➡️ right heart failure

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7
Q

With which COPD patients do you need to be careful about giving oxygen to? Why?

A

Blue bloaters - their resp centres are insensitive to CO2 and so rely on hypoxic drive to maintain resp effort

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8
Q

What are the 4 main symptoms of COPD?

A

Cough
Sputum
Dyspnoea
Wheeze

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9
Q

What is polycythemia and how is it relevant in COPD?

A

Incr RBC production in response to hypoxia. Can give a red face. NB - only seen in ‘blue bloaters’.

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10
Q

Why are blue bloaters blue?

A

Cyanosis and polycythemia

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11
Q

What are the two COPD treatments that can improve prognosis?

A

Smoking cessation

02 therapy

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12
Q

Why is pneumothorax a complication of COPD?

A

Bullae (air pockets in lungs; emphysema) can rupture

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13
Q

Why is lung carcinoma a potential COPD complication?

A

?? Chronic inflammation??

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14
Q

What might a COPD CXR show? (5 things)

A 
Hyperinflation (>6 anterior ribs above diaphragm in mid clavicular line)
Flat hemidiaphragms
Large central pulmonary arteries
Bullae
Decreased peripheral lung markings
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15
Q

What does FEV1 need to be to diagnose COPD?

A

<80% predicted

16
Q

What does FEV1/FVC need to be to diagnose COPD?

A

<0.7: ie an obstructive picture

17
Q

What will total lung capacity and residual volume be in COPD?

A

Increased TLC and RV

18
Q

What will the gas transfer efficient be in COPD (emphysema)?

A

DLCO = Decreased

20
Q

What might a COPD ECG show? And in what circumstance?

A

Right atrial and ventricular hypertrophy in Cor Pulmonale.

21
Q

How do you treat an acute exacerbation of COPD?

A

Incr bronchodilator use

30mg oral prednisolone for 7-14 days

22
Q

How do you classify COPD severity?

A

Mild: FEV1 > 80% predicted
Moderate: FEV1 = 50-79% predicted
Severe: FEV1 = 30-49% predicted
Very severe: FEV1 < 30% predicted

23
Q

What is the non pharmacological treatment for all COPD (regardless of severity)?

A 
Smoking cessation
Incr exercise
Treat poor nutrition and obesity
Influenza and pneumococcal vaccination
Pulmonary rehabilitation
24
Q

What is the pharmacological treatment for all COPD (regardless of severity)

A

PRN - SAMA (ipratropium) SABA (salbutamol)

25
Q

How would you treat mild/moderate COPD?

A

LAMA (tiatropium) or LABA (salmeterol)

26
Q

How would you treat severe COPD?

A

LABA + corticosteroid: eg. SYMBICORT (formeterol + budesonide)
OR
LAMA (tiotropium)

27
Q

How would you treat COPD that remained symptomatic despite severe treatment options?

A

LAMA + inhaled steroid + LABA

28
Q

When should you consider oxygen therapy in COPD? Consider:

1) Clinically stable non-smokers
2) Those with plum hypertension, polycythaemia, peripheral oedema, nocturnal hypoxia

3) When else might you prescribe oxygen?

A

1) When O2

29
Q

When can COPD not be caused by smoking?

A

Alpha1-antitrypsin deficiency

30
Q

Describe the process by which alpha1-antitrypsin deficiency can cause COPD?

A

Finish

31
Q

If you are worried about hypoxic respiratory drive in COPD patients, what O2 sats should you aim for?

A

88-92%

32
Q

What is the indication for hypoxic drive in COPD patients?

A

Chronic hypercapnia

Respiratory (11 decks)

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