COPD Flashcards
What 2 conditions is COPD comprised of?
Emphysema + Chronic bronchitis (ain’t nobody got time fo dat)
What is chronic bronchitis?
Chronic neutrophilic inflammation in the bronchi/bronchioles, causing mucus hypersecretion and bronchospasms
What is emphysema?
Alveolar collapse, leading to impaired gas exchange
COPD patients have a productive cough, progressive breathlessness and frequent infective exacerbations. True/False?
True
What is an epidemiological definition of chronic bronchitis?
Cough + sputum on most days for at least 3 months of 2 successive years
Describe how cor pulmonale (pulmonary heart failure) arises due to emphysema
Decreased gas exchange leads to decreased PaO2, which causes pulmonary vasoconstriction, increasing pressure in pulmonary arteries and thus the right side of the heart
Emphysema is common in people who are deficient of which antiprotease?
a1-antitrypsin
How does tobacco smoke affect the lung?
Increases no. of neutrophils and macrophages
Inhibits a1-antitrypsin
What are the 4 main symptoms of COPD?
Productive cough Wheeze Breathlessness Infective exacerbations TYPICALLY SMOKERS
What is the average % bronchodilator response in COPD?
Less than 15%
Outline treatment for mild to severe COPD
SAMA (mild)
SAMA + LAMA + LABA (moderate)+ ICS (severe frequent exacerbations)
Outline treatment for acute exacerbation of COPD
Ipratropium neb Salbutamol neb Oxygen (24%) Antibiotics if purulent sputum Prednisolone oral
List the pathological pathway involved in COPD
CD8 + lymphocyte, cigarette smoke
- –>alveolar macrophage
- –>neutrophil
- –>protease imbalance
- –>inflam change in airways and progressive airflow limitation
Outline non-pharmacological treatment used in COPD
Smoking cessation Immunisation Exercise Oxygen domicillary Venesection
