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ESA 3 - Respiratory System > COPD > Flashcards

COPD Flashcards

1
Q

What is Chronic Obstructive Pulmonary Disease (COPD)?

A

A chronic, slowly progressive disease disorder characterised by airflow obstruction, which does not charge markedly over several months

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2
Q

What is the effect of airflow obstruction on FEV1?

A
  • Reduced FEV1
  • Reduced FEV1/FVC ratio
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3
Q

What causes COPD?

A

The abnormal inflammatory response of the lung to noxious particles or gases

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4
Q

Where can noxious particles or gases come from?

A
  • Cigarette smoke
  • Atmospheric pollutants
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5
Q

What components of cigarette smoke cause lung inflammation?

A
  • Biomass particles
  • Particulates
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6
Q

What can make the inflammation caused by cigarette smoke worse?

A
  • Host factors
  • Amplifying mechanisms
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7
Q

How does lung inflammation from cigarette smoke cause COPD?

A
  • Directly
  • Oxidative stress
  • Proteinases
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8
Q

What attempts to protect against oxidative stress?

A

Anti-oxidants

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9
Q

What attempts to protect against the action of proteinases?

A
  • Anti-proteinases
  • Repair mechanisms
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10
Q

What is a much less common cause of emphysema?

A

Inherited deficiency of α1-antitrypsin

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11
Q

What are the symptoms of COPD?

A
  • Productive cough
  • Wheeze
  • Breathlessness
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12
Q

What does the productive cough in COPD produce?

A

White or clear sputum

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13
Q

What does COPD usually follow?

A

Many years of smokers cough

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14
Q

What are the signs of COPD?

A
  • May be no signs
  • Quiet wheezes
  • Hyperventilation with prolonged expiration (in prolonged disease)
  • Accessory muscles of respiration used
  • Hyperinflation of the lungs
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15
Q

Why is there hyperventilation with prolonged expiration in COPD?

A

Expiratory airflow limitation

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16
Q

What factors are considered when assessing COPD?

A
  • History
  • Chest X-ray
  • FEV1
  • Other lung function tests
  • High resolution CT scan
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17
Q

What must the history include when assessing COPD?

A

The MRC dyspnoea scale

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18
Q

What would constitute grade 1 on the MRC dyspnoea scale?

A

Not troubled by breathlessness except on strenuous exercise

19
Q

What constitutes grade 2 on the MRC dyspnoea scale?

A

Short of breath when hurrying or walking up a slight hill

20
Q

What constitutes grade 3 on the MRC dyspnoea scale?

A

Walks slower than contemparies on level ground because of breathlessness, or has to stop for breath when walking at own pace

21
Q

What constitutes grade 4 on the MRC dyspnoea scale?

A

Stops for breath after walking about 100m, or after a few minutes on level ground

22
Q

What constitutes grade 5 on the MRC dyspnoea scale?

A

Too breathless to leave the house, or breathless when dressing or undressing

23
Q

What other lung function tests are carried out to assess COPD?

A
  • Lung volumes
  • Loop
24
Q

What is the purpose of a chest x-ray in the assessment of COPD?

A

Not really to diagnose COPD, mainly to make sure they don’t have something else, e.g. cancer

25
Q

What is the purpose of a high resolution CT scan in the assessment of COPD?

A

Detect emphysema

26
Q

What happens in spirometry?

A

The patient fills their lungs from the atmosphere, and breathes out as far and fast as possible through a spirometer

27
Q

What does simple spirometery allow for?

A

Measurement of many lung volumes and capacities

28
Q

What is the purpose of oxygen therapy?

A

To increase oxygen saturation and alleviate symptoms

29
Q

What is oxygen therapy a treatment for?

A

Hypoxaemia, not breathlessness

30
Q

What are the advantages of oxygen therapy?

A
  • Long term
  • Portable
  • Intermittent
31
Q

How is COPD managed?

A
  • Smoking cessation
  • Drug therapy
  • Oxygen therapy
  • Pulmonary rehabilitation
  • α1-antitrypsin replacement
  • Treat co-morbid condition
32
Q

What is the single most useful measure in the management of COPD?

A

Persauding the patient to stop smoking

33
Q

What is the effect of smoking cessation in advanced disease?

A

May slow down the rate of deterioration

34
Q

What is the purpose of drug therapy in the management of COPD?

A

Used for both the short-term management of exacerbations and the long-term relief of symptoms

35
Q

What drugs are used in the treatment of COPD?

A
  • Bronchodilators
  • Corticosteroids
  • Antibiotics
36
Q

What kind of drugs are bronchodilators?

A

ß2-adrenoagonists

37
Q

What is the purpose of corticosteroids in the treatment of COPD?

A

Immunosuppressive

38
Q

What is the purpose of antibiotics in the treatment of COPD?

A

Shortens exacerbations

39
Q

When are antibiotics given in COPD?

A

As soon as sputum turns yellow or green

40
Q

What is meant by pulmonary rehabilitation?

A

Exercise training

41
Q

What does exercise training do in COPD?

A

Can modestly increase exercise capacity

42
Q

How is pulmonary rehabilitation conducted?

A

Regular training periods can be used at home

43
Q

Give two examples of exercises that may be used in pulmonary rehabilitation

A
  • Walking fixed distances
  • Climbing stairs
44
Q

What are the co-morbidities for COPD?

A
  • Cardiac
  • Metabolic
  • Nutritional
  • Osteoporosis
  • Anxiety/depression

ESA 3 - Respiratory System (14 decks)

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