COPD Flashcards
What is COPD?
A progressive disorder characterised by airway obstruction (FEV1/FVC < 0.7) that is irreversible (i.e. salbutamol won’t help). It encompasses emphysema and chronic bronchitis.
What are the risk factors of COPD?
Age of onset >35 Smoking Pollution Genetics Being white/ male/ poor Abnormal lung development
What is the epidemiology of COPD?
Prevalence = 10-20% of the over- 40s
2.5 x 10^6 deaths per year worldwide
What are the signs and symptoms of COPD?
Cough SOB Sputum Wheeze Barrel chest Fatigue Headache Tachypnoea, use of accessory muscles Hyper resonant chest Distant breath sounds, poor air movement, wheezing and coarse crackles Cyanosis Asterixis Distended neck veins, hepatojugular reflex Swelling (lower extremities) Clubbing Hepatosplenomegaly
What investigations can you do for COPD?
Pulse oximeter
Low oxygen sats
FBC
Increased PVC
CXR Hyperinflation Flat hemidiaphragms Large central pulmonary arteries Reduced peripheral vascular markings bullae
ECG
Right atrial and ventricular hypertrophy (cor pulmonale)
ABG
Low PaO2 plus hypercapnia
Spirometry FEV1 < 80% FEV1/FVC <70% Increased TLC/RV DLCO reduced
What are the complications of COPD?
Cor Pulmonale- oxygen therapy
Recurrent pneumonia- Antibiotics, pneumococcal vaccination
Depression- lifestyle, therapy, antidepressants
Pneumothorax- conservative management or chest drain
Respiratory failure- non invasive positive pressure ventilation/ mechanical ventilation
Anaemia
Polycythaemia
What is the management of COPD?
Lifestyle- smoking cessation and diet advice
Mucolytics
Flu treatments
Long term oxygen therapy
What is the prognosis of COPD?
Depends on severity of disease based on FEV1
Use BODE index
Resp failure has poor prognosis
