COPD Flashcards

1
Q

What are the two conditions that COPD is an umbrella term for?

A

Empysema and chronic bronchitis

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2
Q

What is COPD?

A

Characterised by airflow obstruction hat is usuallly prgoreesive, and that is not fully reversible

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3
Q

What is empysema?

A

Is a pathological proccess in which there is destruction of the terminal brochioles and distal airspaces

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4
Q

What is the effect of a destruction of supporting tissue in empysema?

A

Airways collapse or close in vetnilitaion, and there is airflow obstruction affecting the small airways

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5
Q

What is the effect of the loss of elastic tissue in empysema?

A

This causes the lungs to hperinflate, as the lungs are unable ot resist the natural movement of the chest wall to expand outwards

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6
Q

What is chronic brochitis?

A

Chronic mucus secretion, that is often causes by airway inflamtion, which is often caused by smoking

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7
Q

What are the main causes of COPD?

A

Smoking (the main causes) occuaapational exposures such as coal dust, pollution, alpha 1 antitrypin defincey

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8
Q

What are the symptoms of COPD?

A

Coungh and sputum production is often the first symptom, and then there is progressive breathlessness

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9
Q

What are some of the signs of COPD?

A

Purse lipped breathing, tachypneoa, using the accessory muscles to help with breathing, wheeze and quite breath sounds on asculation, hyperinflation, and in more advanced cases there is cyanosis, CO2 reterntion

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10
Q

How does hyperinflation of the lungs cause breathlessness?

A

As the diaphram and the other muscles and this squishes the diaphram and makes it harder for these muscles to expand the chest cavity

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11
Q

What are some of the features of the spirometery of a COPD paitnet?

A

The FEV1 <80% the predicted value, and the FEV1/FVC <70%, as there is limited expiration of the air during the first second

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12
Q

What are some of the features of making a diagnosis of COPD?

A

Breathlessness that is usually persistant and progressive, smoker or ex smoker and a older patietn, and a chronic productive cough as well as the features of spirometery

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13
Q

What is the care bundle in the managment of stable COPD?

A

Mycolytics, diet- suplpements and a dietican revue, pulmonary rehabiliation, brohcodilators, antimuscarinas steriods, and long term oxygen thearpy as well as supportive treatments such as the flu vacicne

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14
Q

What are some of the drugs that might be used in COPD?

A

Steriods, inhaled, brochodilators, mucolytics, methylxamines, antimuscarinics

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15
Q

What is the mechanism of action of B2 adrenoreceptors such as salbuatmal?

A

Ligand binds to the receptor activates the adenyly cyclase which increases the cAMP activating protein kinase A, phosphorylation of downstream targets, reduction of smooth msucle, and this causes brochodiliation

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16
Q

What are some of the adverse effects of B2 agnoists such as salbutamol?

A

Hypokalmeia, tachcardia, tremor and aniwxity

17
Q

What is the mechanism of action of anticholdingerics?

A

Syngersit wiht B2 agnoist

18
Q

What are the local adverse action of anticholingerics?

A

Dry mouth and cough, sore mouth, bitter taste and upper resp tract infections

19
Q

What are some of the systemic effects of anticholingerics?

A

Supraventiculuar tachcardia and constiplastin, urianry diffculty and atrial fibrillation as well as urainary ifficuluty

20
Q

What is the mode action of methylaxinlines?

A

Mode of action include anti inflammtoryies, brochodilation,

21
Q

What is the mechanism of methylacines?

A

Inhbits phosphodiesterases

22
Q

What are the surgical options for the treatment of COPD?

A

There is a lung volume reduction and therefore a reduction in hyperinflation, and a lun transplant that may be option in younger patients

23
Q

How would you manage a acute exaberation of COPD?

A

Aim for sats 88-92%, and use nebulisers such as brochoidlators, and steriod, antibitotics if there are infective features,

24
Q

What are some of the contradindications for NIV?

A

Untreated pneumonia, upper airwt. Secretions, vomiting, agiated