COPD Flashcards
What is COPD?
Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness.
What is the main cause of COPD?
Smoking
What are the causes of COPD?
Smoking
Pollution and fumes - in very polluted areas/countries.
At diagnosis, what % of lung function is already lost in COPD?
20-30%
What drives COPD forward, in terms of disease progression?
Infections/exacerbations cause COPD to become more severe overtime.
Outline the main clinical features of COPD
Exertional dysponea
Cough
Sputum production
Wheeze
What is dysponea?
Difficulty breathing (usually upon exertion in COPD)
What are common misdiagnosis of COPD?
Asthma, bronchiectasis, lung cancer
How can stopping smoking help patients with COPD?
If you stop smoking at any point your lung function will go back to decreasing at the rate of a non-smoker
Why do we only use ICS/LABA combination inhalers as third line treatment?
ICS/LABA inhalers have been associated with increase risk of pneumonia.
what is meant by an acute exacerbation of copd? What sort of symptoms might a patient be experiencing?
A sustained worsening of the patients condition, from the stable state and beyond normal day to day variations.
Increased SOB, worsening cough, increased sputum production, change in sputum colour.
What two vaccinations should be recommended to people with COPD?
One off pneumococcal and annual influenza
How should an acute exacerbation of COPD be managed?
- Bronchodilator - salbutamol 2.5mg 4 hrly and ipratropium 500ugm qds
- Steroids - prednisolone 30mg 7-10 days
- Antibiotics - if consolidation on CXR treat as pneumonia
VTE prophylaxis
Consider carbocisteine.
What are the oxygen target sats in COPD?
88-92% lower than normal
Do steroid doses need to be tapered after an acute COPD attack?
Usually no need for tapering dose as only for 7-10 days.
How can you calculate a patients number of pack years?
Number of cigarettes smoked per day / 20 and multiplied by the number of years smoked
What age is COPD generally seen in?
Over 40 years
Why do patients with COPD have lower oxygen sats targets?
At risk of hypercapnic drive leading to respiratory depression
A FEV1 reading of 60-80% indicates what about COPD severity?
Mild severity