COPD Flashcards
What is COPD characterised by?
Obstruction of airflow
What is COPD predominantly caused by?
Smoking
(Can also be caused by a1 antitrypsin defiency in 1%)
(Also occupational exposure, pollution)
COPD is an umbrella term encompassing what?
Emphysema and chronic bronchitis
What is emphysema?
A pathological process in which there is destruction of the terminal bronchioles and distal airspaces, leading to loss of alveolar surface area
What are pulmonary bullae?
Focal regions of emphysema - large redundant airspaces
Why do emphysematous lungs hyperinflate?
Loss of elastic tissue - can’t recoil and resist the natural tendency of the rib cage to expand outwards
What does chronic bronchitis refer to?
Chronic mucus hypersecretion caused by inglammation in the large airways leading to proliferation of mucus producing cells
How does chronic bronchitis result in airflow obstruction?
Remodelling and narrowing of the airways
What percentage of smokers will develop COPD?
Approx 15%
What are the symptoms of COPD?
Persistant productive cough, increasing breathlessness
What does the MRC dyspnoea score measure?
Grade of breathlessness related to activities
What are some signs that a patient has COPD?
Purse lip breathing, tachpnoea, using accessory muscles
Hyperinflation - barrel chest
How is airflow obstruction described on spirometry?
FEV1 < 80% predicted
FEV1/FVC ratio < 70%
In COPD, is the limitation to the flow of air during inspiration or expiration?
Expiration (so FEV1 is reduced)
What is involved in the management of COPD?
Smoking cessation, pulmonary rehabilitation, bronchodilators, antimuscarinics, steroids, long term oxygen therapy
