COPD

Question 1

What 2 conditions is COPD comprised of?

Answer 1

Emphysema + Chronic bronchitis

ain’t nobody got time fo dat

Question 2

What is chronic bronchitis?

Answer 2

Chronic neutrophilic inflammation in the bronchi/bronchioles, causing mucus hypersecretion and bronchospasms

Question 3

What is emphysema?

Answer 3

Alveolar collapse, leading to impaired gas exchange

Question 4

COPD patients have a productive cough, progressive breathlessness and frequent infective exacerbations. True/False?

Answer 4

True

Question 5

What is an epidemiological definition of chronic bronchitis?

Answer 5

Cough + sputum on most days for at least 3 months of 2 successive years

Question 6

What is meant by centriacinar emphysema?

Answer 6

Emphysema affecting proximal respiratory bronchioles; alveolar ducts + sacs remain in tact

Question 7

What is meant by panacinar emphysema?

Answer 7

Emphysema affecting terminal bronchioles; destruction of whole alveolus

Question 8

Describe how cor pulmonale (pulmonary heart failure) arises due to emphysema

Answer 8

Decreased gas exchange leads to decreased PaO2, which causes pulmonary vasoconstriction, increasing pressure in pulmonary arteries and thus the right side of the heart

Question 9

Emphysema is common in people who are deficient of which antiprotease?

Answer 9

a1-antitrypsin

Question 10

How does tobacco smoke affect the lung?

Answer 10

Increases no. of neutrophils and macrophages

Inhibits a1-antitrypsin

Question 11

What are the 4 main symptoms of COPD?

Answer 11

Productive cough
Wheeze
Breathlessness
Infective exacerbations

Question 12

What is the average % bronchodilator response in COPD?

Answer 12

Less than 15%

Question 13

Outline treatment for mild to severe COPD

Answer 13

SAMA (mild)
SAMA + LAMA + LABA (moderate)
+ ICS (severe frequent exacerbations)

Question 14

Outline treatment for acute exacerbation of COPD

Answer 14

Ipratropium neb
Salbutamol neb
Oxygen (24%)
Antibiotics if purulent sputum
Prednisolone oral