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Resp AM > COPD > Flashcards

COPD Flashcards

1
Q

What is COPD?

A

Progressive disease state characterised by airflow obstruction that is not fully reversible
Encompasses 2 conditions- emphysema and chronic bronchitis

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2
Q

What is emphysema?

A

Widening of airways distal to terminal bronchioles

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3
Q

What is chronic bronchitis?

A

Chronic inflammation of airways

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4
Q

What are the common causative organisms of acute exacerbations of COPD?

A

Most common= H. influenzae
Strep pneumonia
Moraxella catarrhalis

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5
Q

What are the risk factors for COPD?

A

SMOKING!
alpha1 antitrypsin deficiency- think about in <50 and non smokers
Age
Pollution

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6
Q

What is the classic presentation of COPD?

A

Cough- worse in morning, productive
Progressive SOB
History of smoking

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7
Q

What are some of the less common presenting features of COPD?

A

Barrel chest
Hyper-resonance
Wheeze
Coarse crackles

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8
Q

What is the presentation of an acute exacerbation of COPD?

A

Increased severity and frequency of cough with change in sputum
SOB and wheeze
Fever, chills, malaise

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9
Q

Hw is COPD diagnosed?

A

Clinical picture and spirometry

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10
Q

What is seem on spirometry with COPD?

A

Obstructive picture= FEV1/FVC <0.7

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11
Q

What investigations should be considered in COPD?

A

CXR
ECG
FBC
Serum alpha 1 antitypsin

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12
Q

What investigations should be done in an acute exacerbation of COPD?

A

ABG
FBC, U&Es, sputum and blood cultures
CXR
ECG

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13
Q

What is the single most effective intervention for COPD?

A

Smoking cessation

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14
Q

What are the management options for COPD?

A

Smoking cessation
Lifestyle measures- weight loss, exercise
Pharmacological
Oxygen therapy

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15
Q

What is step 1 in chronic COPD management?

A

SABA or SAMA

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16
Q

What is step 2 in chronic COPD management?

A

Assess if steroid responsive

  • yes= add LABA + ICS
  • no= add LABA and LAMA
17
Q

What is step 3 in chronic COPS management?

A

SABA + LABA + ICS + LAMA

18
Q

What are some adjuncts used in chronic COPD management?

A

Oral corticosteroids
Oral theophylline
Long term prophylactic antibiotics
Long term oxygen therapy

19
Q

What are the indications for long term oxygen therapy in COPD?

A 
FEV1 <30% predicted 
Cyanosis
O2 sats <92% on air
Polycythaemia 
peripheral oedema 
Raised JVP
20
Q

How is O2 given in COPD?

A

Venturi mask

21
Q

When should prophylactic antibiotics be considered in COPD?

A

3 infective exacerbations in 1 year

22
Q

What is the management of acute exacerbations of COPD?

A

Bronchodilators- nebuliser
Corticosterodis- inhaled or IV
Infective= antibiotics

23
Q

What are some complications of COPD?

A

Cor pulmonale
Recurrent pneumonia
Reduced QOL and depression

Resp AM (17 decks)

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