COPD Flashcards
How do you calculate pack years?
No. of pack years = ( no. of cig. smoked per day x no. of years smoked ) / 20
Aetiology of COPD
Smoking Age Gender Occupation Genetic Factors Air Pollution Socio-economic Status
What is the pathophysiology (conditions typically observed) of COPD?
Chronic bronchitis (inflammation and excess mucus) Emphysema - alveolar membranes break down and equals dead air space
Describe the flowchart of pathophysiology that starts with noxious particles or gases and give an example of this cause
Inflammation
- gas exchange abnormalities
- mucus hypersecretion
- airflow limitation and air trapping
What age of a smoker indicates potential COPD?
> 35 years old
What other clinical observations can be used for diagnosis?
Spirometry
X Ray
Symptoms of COPD
Breathlessness when exerting themselves Chronic cough Regular sputum production Frequent winter chest infections Wheeze
Signs of COPD
Older patients (>35 years) Hyperinflated chest Wheeze or quiet breath sounds Pursed lip breathing Peripheral oedema Cyanosis Clubbing of nails Nicotine staining on fingers and nails Underweight Use of accessory muscles
What are Pink Puffers? Describe and name cause
Emphysema - skinny drawn
What are Blue Bloaters? What is the cause and describe
Chronic bronchitis
Not underweight - fat reseveres
How is COPD a systemic disease?
Muscle weakness
Depression
Pulmonary hypertension
Osteoporosis
What spirometry results would we expect for a patient with COPD ?
FEV1 : FVC ratio of
What can reduce the rate of decline in FEV ?
Smoking cessation ( NRT / cold turkey / New Leaf )
What are the aims of COPD treatment?
- prevent and control symptoms
- reduce frequency and severity of exacerbations
- improve quality of life
- improve tolerance to exercise
- prevent disease progressions
- minimal side effects
What things should be considered before stepping up a patients therapy
Review ; patients inhaler technique / adherence / smoking status / attendance at pulmonary rehab / signs of anxiety or depression
