COPD Flashcards
1
Q
Define COPD
A
- a disease state characterized by airflow limitation that is not fully reversible’
2
Q
What causes COPD
A
- long term exposure to toxic particles and gases
- smoking accounts for over 90% of cases
3
Q
Explain the pathophysiology of COPD
A
- Increased mucus-secreting cells
- squamous epithelium replaces columnar cells
- inflammation –> scarring and thickening of walls
- fibrosis of bronchial walls
4
Q
What lymphocyte cell is involved in COPD
A
CD8+ –> Tc1 cell
5
Q
What 2 conditions make COPD
A
- Empysema
- Chronic bronchitis
6
Q
What is empysema?
A
- abnormal and permenant enlargement of airspaces
- loss of elasticity of alveoli walls
7
Q
What is chronic broncitis?
A
- hypertrophy and hyperplasia of bronchial mucous glands
- increase in mucus production
8
Q
What is acute exacerbation of COPD?
A
- Infections in patients with COPD
- Promt use of antibiotics is required
9
Q
Explain the cascade in emphysema?
A
- Exposure to irritants
- inflammatory cells
- release of leukotrines (IL 8)
- Destroy collagen and elastin
- loss of elasticity
- alveoli walls collapse
10
Q
Symptoms of Emphysema
A
- barrel chest (hyperinflation)
- weight loss
- pursed lips
- dyspnea
- cough
- pink puffers
11
Q
Explain the cascade of chronic bronchitis?
A
- irritants
- hypertrophy/hyperplasia of mucosal cells
- increase in mucus
- blocked airflow
- less O2 reaches blood (hypoxemia)
- hypercapnia (high co2 in blood)
12
Q
Symptoms of chronic bronchitis
A
- wheezing
- crackles
- hypoxemia
- hypercapnia
- cyanosis
- blue bloaters
13
Q
Symptoms of COPD
A
- Productive cough
- white or clear sputum
- wheeze
- breathlessness
- hypertension
- weight loss
14
Q
What is pulmonary hypertension
A
- cyanosed
- fluid retention and peripheral oedema
- failure of excretion of sodium and water due to hypotxic kidneys
- right ventricular hypertrophy
15
Q
COPD investigations
A
- Lung function tests
- CXR (often normal)
- Blood gases
16
Q
Drugs of COPD
A
- SABA (salbutamol)
- SAMA (ipratropium)
- LAMA/LABA (formoterol and tiotropium)
- TRIPLE inhaler (formoterol, tiotropium,beclomethasone)
17
Q
Treatment of acute COPD
A
- Nebulised high dose salbutamol + ipratropium
- Oral prednisolone
- Antibiotic (amoxycillin/doxycycline) if infection
18
Q
What type of respiratory failure is associated with COPD?
A
- Type 1 or 2 respiratory failure
- most have type 1 but can go on to develope type 2
