COPD Flashcards

1
Q

Define COPD

A
  • a disease state characterized by airflow limitation that is not fully reversible’
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2
Q

What causes COPD

A
  • long term exposure to toxic particles and gases

- smoking accounts for over 90% of cases

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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
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4
Q

What lymphocyte cell is involved in COPD

A

CD8+ –> Tc1 cell

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5
Q

What 2 conditions make COPD

A
  • Empysema

- Chronic bronchitis

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6
Q

What is empysema?

A
  • abnormal and permenant enlargement of airspaces

- loss of elasticity of alveoli walls

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7
Q

What is chronic broncitis?

A
  • hypertrophy and hyperplasia of bronchial mucous glands

- increase in mucus production

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8
Q

What is acute exacerbation of COPD?

A
  • Infections in patients with COPD

- Promt use of antibiotics is required

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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
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10
Q

Symptoms of Emphysema

A
  • barrel chest (hyperinflation)
  • weight loss
  • pursed lips
  • dyspnea
  • cough
  • pink puffers
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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)
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12
Q

Symptoms of chronic bronchitis

A
  • wheezing
  • crackles
  • hypoxemia
  • hypercapnia
  • cyanosis
  • blue bloaters
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13
Q

Symptoms of COPD

A
  • Productive cough
  • white or clear sputum
  • wheeze
  • breathlessness
  • hypertension
  • weight loss
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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
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15
Q

COPD investigations

A
  • Lung function tests
  • CXR (often normal)
  • Blood gases
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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