COPD Flashcards
What are causes of COPD?
Smoking
Genetics (alpha 1 antitrypsin deficiency)
Race- Chinese and Afro-Caribbeans reduced likelihood
Diet- poor diet and low birthweight
What are the 2 classical presentations of COPD and explain them?
Blue bloater: CO2 unresponsiveness causes retention, cyanosis, crackles and wheeze, oedema and productive cough.
Pink Puffer: CO2 responsive so barrel chest, pursed lips and tachypnoea with cough and cachetic appearance. Quiet chest and flattened diaphragm. There is permanent damage that enlarged the air spaces
What investigations are done in COPD?
FEV1 FVC FEV:FVC - under 70% is criteria for diagnosing airflow obstruction Sputum culture CXR FBC BMI alpha1antitripsn ECG/Echo if cor pulmonale suspected
Is night waking common In COPD?
No- more asthma
Do you expect much variability in PEFR?
No
What are the non pharmaceutical measures to be taken in COPD?
Smoking cessation
Vaccination- pneumococcal and annual flu
Exercise- pulmonary rehab
Nutrition- weight loss (improves exercise tolerance)
What is the first stage of COPD management?
SAMA or SABA as needed
What is the first stage of COPD?
Breathless on exercise and limited
What is stage 2 COPD?
Persistent breathlessness
What is the management for stage 2 COPD with FEV1 >50?
LABA
LAMA
What is the management for stage 2 COPD with FEV1 <50?
LABA and ICS combined inhaler
LAMA
What is the 3rd line therapy for COPD?
LABA and LAMA and ICS
When is oxygen therapy indicated in COPD?
When FEV1 <30% Hypoxaemia (02 less than 92% on air) Cyanosis Raised JVP Peripheral oedema Polycythaemia
What causes COPD exascerbations?
30% no cause
Infection
Pollutants
What pathogens cause infection in COPD?
Strep pneumonia
Haemophilus influenzae
