COPD Flashcards
Which two questionnaires are used to assess a patient’s COPD symptoms?
MRC and CAT.
What does the MRC questionnaire assess?
Dyspnoea (breathlessness).
What does the CAT questionnaire assess?
General COPD symptoms.
What is one major drawback to using inhaled corticosteroids in COPD?
Greater risk of URTIs.
In the NICE guidelines, what does ‘features suggesting steroid responsiveness’ mean?
High eosinophil count.
What is the first line pharmacological treatment suggested by NICE for the treatment of COPD?
Offer SABA or SAMA to use as needed.
Which two organisations provide guidelines for the treatment of patients with COPD?
NICE and GOLD.
If a patient with COPD is limited by symptoms or has exacerbations despite treatment, and has no features suggesting asthma or steroid responsiveness, what treatment should be offered?
Offer LAMA and LABA.
If a patient with COPD has been given a LAMA and a LABA and still has symptoms that adversely impact their quality of life, what should be considered?
A 3-month trial of LABA, LAMA and ICS.
If a patient with COPD is limited by symptoms or has exacerbations despite treatment, and has features suggesting asthma or steroid responsiveness, what treatment should be considered?
LABA and ICS.
If a patient with COPD and asthmatic or steroid responsiveness features has been given a LABA and an ICS but still has symptoms adversely impacting their QOL or they have exacerbations (1 severe or 2 moderate) in a year, what should be considered?
LAMA, LABA and ICS.
What are some causes of exacerbations in COPD?
URTI. Exposure to certain compounds (pollution). Severe allergic responses. Weather changes. Overexertion. Lack of sleep. Stress/anxiety.
What are some factors which influence the progression and development of COPD?
Diet and nutrition. Low socioeconomic status. Physical activity. Genetics. Lung growth and development in gestation. Frequent RTIs in childhood. Age. Asthma.
How is diagnosis and initial assessment of COPD made?
Spirometry. Incidental findings from other tests. Sputum culture. Bronchodilator reversibility test. History taking.
How frequent is follow up carried out for patients with stages 1 to 3 COPD?
Every year.
How frequent is follow up carried out for patients with stage 4 COPD?
At least twice a year.
What is the greatest cause of COPD?
Smoking.
Describe cor pulmonale.
Abnormal enlargement of the right side of the heart due to disease of the lungs or pulmonary blood vessels.
If a patient with COPD presents with cor pulmonale, what course of action should be taken?
Referral to a specialist.
How is peripheral oedema secondary to COPD treated?
With furosemide.
If a patient with a COPD presents with abnormal BMI, what course of action should be taken?
Referral to dietician.
If a patient with COPD presents with a BMI lower than 18.5, what course of action would a dietician take?
Nutritional supplementation.
If a patient with COPD presents with a BMI higher than 25, what course of action would a dietician take?
Weight loss.
What may be used to treat a chronic productive cough in a patient with COPD?
A mucolytic e.g. carbocisteine.
If a patient presents with severe COPD and hypoxaemia, what treatment is required?
Long term oxygen therapy (15 hours a day).
Describe the treatment required when a patient presents with an exacerbation of COPD.
Nebulised bronchodilators (ipratropium or salbutamol). Antibiotics if suspected infection. 7–14-day course of oral corticosteroids if breathlessness interferes with day-to-day life.
