copd Flashcards
what is the pathophysiology of COPD?
there is infiltration of inflammatory cells into the bronchi eg. lymphocytes CD8
these cause ulceration of the epithelial layer and cell change of columnar to squamous cells
the squamous cells then cause metaplasia and fibrosis causing scarring and narrowing of the airways- bronchitis part
emphysema- there is destruction of the alveoli at the terminal bronchiole causing loss of recoil and loss of function of expiration causing air trapping and decreased capacity for air exchange
mucous then blocks airways
what are the 4 PCs of COPD?
- dyspnoea
- wheeze
- cough
- sputum
what heart condition is common as a result of COPD?
cor pulmonale
what are the signs of COPD?
- pursed lips
- clubbing
- barrel chest
- reduced expansion
- hyperresonant chest
- decrease cricosternal distance
- use of accessory muscles
- cyanosis
what is a normal FEV1/ FVC value?
80%
what FEV1/FVC is diagnostic of COPD?
70%
what is indicative of COPD of an xray?
- flattened hemi diaphragms
- bulla
- very visible hilar
- hyperinflation, more than 6 anterior ribs
- large central pulmonary arteries
what are the complications of COPD?
- cor pulmonale
- pnuemothorax due to bulla rupturing
- lung carcinoma
- resp failure
what changes would be seen on the ECG?
right atrial and ventricular hypertrophy (cor pulmonale)
what will the ABG results show?
low PaO2 , hypercapnia, bicarb compensation
what 5 investigations can be done to diagnose COPD?
- spirometry
- steroid trial
- ABG
- CXR
- bronchodilator response
which vaccine should be given in the treatment of COPD?
pnuemococcal vaccine
what is the treament for mild COPD?
- antimuscaring - ipratropium
- B2 agonist inhaled when needed
what is the treatment for moderate COPD?
- add LADA- salmetrol
- inhaled steroid- fluticasone
- oral theophylline
what are blue bloaters?
chronic bronchitis- CO2 retentive-when you become resistant to CO2 so need hypoxaemia to trigger breathing
- retain fluid so look bloated and cyanosed
- must be careful giving 02 as reduces ventilation
- hypoxic and hypercapnic
-dusky blue colour
also stimulate RBC production - polycythaemia
- type 2 resp failure
