COPD

Question 1

What is PULMONARY DISEASE?

Answer 1

Diseases that affect the lungs
• Airways
• Vasculature
• Parenchyma

Question 2

Typical symptoms:

Answer 2

dyspnea
wheezing,
productive cough
chest pain/discomfort

Question 3

Obstructive Diseases:

Answer 3

• COPD
• Asthma
• Cystic Fibrosis
• Bronchiectasis

Question 4

What are Restrictive lung disease

Answer 4

group of conditions usually caused by infection or due to disorders of the chest wall muscles.
Results in loss of lung compliance
volume.
eg Parkinsons, MS

Question 5

What is COPD?

Answer 5

Progressive lung disease characterised by persistent reduction in airflow.

A mixture of chronic bronchitis and emphysema.

Question 6

What is Chronic Bronchitis?

Answer 6

Inflammation of the bronchi that

leads to airway narrowing

Question 7

What is Emphysema?

Answer 7

Inflammation and enlargement the alveoli

Question 8

What is Asthma?

Answer 8

Episodic bronchoconstriction, airway hyperresponsiveness and exacerbations of airflow obstruction

Question 9

What is Cystic Fibrosis:?

Answer 9

Genetic disorder that results in

overproduction of mucus in the lungs.

Question 10

What is Bronchiectasis?

Answer 10

permanent dilation of bronchi

Question 11

PATHOPHYSIOLOGY of COPD

Answer 11

chronic inflammation which leads to structural changes

Question 12

What happens to the lumen in bronchitis?

Answer 12

Narrowed due to excessive mucus and increased numbers of goblet cells. The cilia also become damaged.

Question 13

How is COPD diagnosed?

Answer 13

• Spirometry
• Symptoms (dyspnea and productive cough)
• Presence of risk factors

Question 14

Risk factors of COPD:

Answer 14

Environmental Factors
• Smoking (active and passive)
• Occupational exposure
• Indoor/Outdoor air pollution
• Allergens
• Infections
Host factors
• Age
• Genetics
• Gender

Question 15

Demographics of COPD:

Answer 15

More common in male than females
More common in Maori
3rd leading cause of death worldwide

Question 16

Demographics of Asthma:

Answer 16

NZ: 25.3% of adults have symptoms
• 11% diagnosed
• Maori – 16.7%, Europeans – 11.4%
• Mortality rates have decreased by 50% in the last two decades.
• Major cause of absence from work.

Question 17

Treatment of COPD:

Answer 17

• Eliminate sources of inflammation
- cigarettes, irritants, recurrent infections
• Treat reversible airway narrowing
- Inhaled/oral bronchodilators or
corticosteroids
- correct hypoxemia
Prevent exacerbations of disease
- vaccination, hygiene, antibiotics

Question 18

Signs and Symptoms of COPD:

Answer 18

• Elderly
• Shortness of breath
• Wheezing/coughing
• Barrel chest
• Easily fatigued
• Muscle weakness/wasting
• Reduced quality of life
• Reduced exercise capacity
• Comorbidities

Question 19

Exercise Recommendations Aerobic:

Answer 19

Aerobic
• F: >3-5 days per week
• I: 30-80% of peak work rates,4-6
dyspnea rating, 3-4 RPE
• T: >30 min per session. May be broken
into intermittent bouts of 5-10 mins
• T: Combination of lower and upper
body aerobic exercise

Question 20

Exercise Recommendations Resistance:

Answer 20

• F: 2-3 non-consecutive days per
week
• I: ≥ 1 set, 10-15 reps @ RPE of 3-6
(60-70% of 1RM)
• T: 8-10 exercises.
• T: Free weights/machines/bands,
body weight. Concentrated on
unsupported upper body exercises.

Question 21

Exercise Recommendations Flexibility:

Answer 21

• F: ≥ 2 days a week
• I: Stretch to point of discomfort
• T: 20-30 seconds per stretch
• T: Static stretching of major muscle groups.
Stretches of the thoracic spine are
indicated.

Question 22

Strategies to manage dyspnea:

Answer 22

• Interval and intermittent training
• Breathing strategies
- Pursed lip breathing
- Patterned breathing

Question 23

Response to Exercise:

Answer 23

• Psychological and quality of life ratings improve quickly but plateau around twelve weeks.
• Longer programmes allow more time for behavioural changes to occur.

Question 24

How would you monitor COPD:

Answer 24

• Dyspnea during exercise using Borg
CR-10 scale
• SpO2
• Fatigue
• BP, HR