COPD

Question 1

What does COPD stand for?

Answer 1

Chronic obstructive pulmonary disease

Question 2

What does COPD comprise of?

Answer 2

Emphysema

Chronic bronchitis

Question 3

What is emphysema?

Answer 3

Destruction of terminal bronchioles and distal airspaces

Question 4

What happens when airspaces are destroyed?

Answer 4

Create larger redundant airspaces = bullae

Poor gas exchange

Question 5

How does emphysema cause airway obstruction?

Answer 5

Destruction of the supporting tissue surrounding the small airways - causes airway collapse during expiration

Question 6

Why is there hyperinflation in emphysema?

Answer 6

Loss elastic tissue

Question 7

What is chronic bronchitis?

Answer 7

Chronic mucus hypersecretion due to inflammation in the large airways

Question 8

How does chronic bronchitis cause airway obstruction?

Answer 8

Remodelling and narrowing of the airways

Question 9

What is the effect of chronic bronchitis?

Answer 9

Productive cough

Frequent infections

Question 10

What can cause COPD?

Answer 10

Smoking
α-1-antitrypsin deficiency
Occupational exposure
Pollution

Question 11

What are the symptoms of COPD?

Answer 11

Progressive breathlessness

Productive cough

Question 12

What is the MRC dyspnoea scale?

Answer 12

Grade 1 = only breathless on strenuous exercise
Grade 2 = Short of breath when hurrying or up slight hill
Grade 3 = Short of breath after 15 mins
Grade 4 = Short of breath after a few mins
Grade 5 = Too short of breath to leave the house

Question 13

What spirometry pattern does COPD have?

Answer 13

Obstructive

Question 14

How is stable COPD managed?

Answer 14

COPD care bundle

• Smoking cessation
• Pulmonary rehab
• bronchodilators
• antimuscarinics
• steroids
• mucolytics
• flu vaccine

Question 15

How is an acute exacerbation of COPD managed?

Answer 15

O2 - aim for sat 88-92%
Nebulisers
Steroids
Antibiotics if required