COPD

Question 1

definition?

Answer 1

A preventable and treatable disease state
characterised by airflow limitation that is
not fully reversible. The airflow limitation is
usually progressive and associated with
an abnormal inflammatory response of the
lungs to noxious particles or gases,
primarily caused by cigarette smoking.
Although COPD affects the lungs, it also
produces significant systemic
consequences.

Question 2

aetiology?

Answer 2

Cigarette smoking
• Industrial exposure ~ dusts, coal, cadmium
• Home exposure ~ wood burning
• Under treated asthma?
• Genetic general
• Genetic alpha 1 antitrypsin deficiency

Question 3

pthology?

Answer 3

Chronic inflammation airways/gas
exchange
• Neutrophil based
• Macrophage driven
• Protease-antiprotease theory

Question 4

copd pathway

Answer 4

Question 5

impacts?

Answer 5

Muco-ciliary disruption ~ impairs clearance
• Mucus hypersecretion
• Airways inflammation
• Alveolar destruction
• Reduction in pulmonary capillary bed

Question 6

spirometric dignosis?

Answer 6

Airflow obstruction FEV1
/FVC <0.70
Mild FEV1 >80% predicted
Moderate FEV1 >50% <80% predicted
Severe FEV1 >30% <50% predicted
Very severe FEV1 <30% or <50% predicted
with chronic respiratory failure

Question 7

complications of COPD?

Answer 7

• Impaired gas exchange
• Airways obstruction ~ fixed
• Reduced exercise tolerance
• Progressive disability
• Recurrent lung infections/exacerbations
• Chronic respiratory failure
• Pulmonary hypertension/cor pulmonale

Question 8

complications of COPD?

Answer 8

Weight loss
• Skeletal muscle wasting/ reduced
oxidative capacity
• Osteoporosis
• Diabetes mellitus
• Ischaemic heart disease