[COPD] Flashcards
80
0.7
the % of FVC which is expired in 1 second at maximum expiration
>=0.8
Reduced due to reduced air escaping
Normal (or increased)
in restrictive there is an equal reduction of FVC and FEV1 due to lung pathology. Sometimes the FEV1 may even be raised due to decreased compliance.
cough + sputum production for most days for 3 months of 2 consecutive years
cough + sputum production for most days for 3 months of 2 consecutive years
enlarged air spaces distal to terminal bronchioles + destruction of alveolar walls
enlarged air spaces distal to terminal bronchioles + destruction of alveolar walls
Pink puffer Blue bloater
increased
decreased
Pink puffer
Blue bloater
high
low
normal or low
near normal
the hypoxic drive
CO2 (relatively)
Type 1 respiratory failure
cor pulmonale
deprives them of their hypoxic drive leading to extreme hypercapnia
deprives them of their hypoxic drive leading to extreme hypercapnia/acid base imbalance
cough sputum wheeze dyspnoea (SOB)
accessory muscles
Tachypnoea
hyperinflation (cricosternal distance<3cm)
resonant/hyperresonant
cor pulmonale
accessory muscles Tachypnoea hyperinflation (cricosternal distance
polycythaemia Cor pulmonale pneumothorax
ruptured bullae (thin walled sac of air)
increased EPO due to 2ry hypoxia
right heart failure
chronic pulmonary arterial hypertension
enlarged
flat hemidiaphragms >6 anterior ribs seen above diaphragm in mid-clavicular line (assess adequacy of inspiration)
normal inflation - anterior end of 7th rib above diaphragm (less than 6 = impaired expansion; >7 suggest hyperinflation)
cor pulmonale
FEV1 <80% of predicted
FEV1:FVC <70% (0.7)
[COPD]: What is the cause of ‘barrel chest’ (large front to back diameter)
Hyperinflation
increased TLC
diffusing capacity of the lung for carbon monoxide
emphysema
the extent to which O2 diffuse from the alveoli in to the RBCs
polycythaemia
smoking cessation
exercise
if PaO2 is <7.3kPa
[COPD]: Tx: what is 1st line drug Tx for with COPD less severe than ‘mild’ severity (2)
Salbutumol
OR
Ipatropium (short acting)
(as needed)
[COPD]: Tx: what is 1st line Tx for ‘mild/moderate’ COPD (2)
Tiotropium (long acting)
or
Salbutumol
Salbutumol
+
corticosteroid
(i.e. symbicort)
OR
Tiotropium
Tiotropium
+
salbutumol
+
corticosteroid
budesonide
+
Formoterol
(long acting)
Symptomatic after adminstration of ‘severe’ stage drugs
M3 antimuscarinic - long acting smooth muscle relaxation
short acting B2 adrenergic agonist causing smooth muscle relaxation
[COPD]: Dx: define Stage 1 ‘general’ COPD
FEV1 >=80%
[COPD]: Dx: define stage 2 ‘mild/moderate’ COPD
FEV1 50-79% of predicted
[COPD]: Dx: define stage 3 ‘severe’ COPD
FEV1 30-49% of predicted
2 week trial of prednisolone
FEV1 rises by >15%
long-term steroid may be helpful
<7.3 kPa
pulmonary hypertension (loud s2/LVH)
Polycythaemia
peripheral oedema
nocturnal hypoxia
low PA02
hypercapnic
recurrent pneumothoraces
isolated bullae
air filled sac
one way valve
(compressive effects)
emphysema
(damagaged alveoli walls + reduced blood flow)
chronic bronchitis
(increased mucus production = obstructed airways = reduced ventilation)
reduces water surface tension
increased lung compliance
[COPD]: Dx: define stage 4 ‘very severe’ COPD
FEV1 <30% of predicted
>3
