COPD Flashcards
What does COPD stand for?
Chronic obstructive pulmonary disease
What is COPD defined as?
Mixed airway reversible obstruction and destructive lung disease
- asthma component
- bronchiectasis and emphysema component
What components of COPD are reversible and non reversible?
Asthma component - reversible
Bronchiectasis and emphysema component - NON reversible
What are two features seen in the bronchi with bronchiectasis?
- damaged cell wall
- Increased mucus
Leads to narrow diameter
What is bronchiectasis characterised by?
Productive cough throughout winter months
What does emphysema do to the alveoli?
- Destruction of alveoli
2. Dilation of others to ‘fill space’
What are the main symptoms of COPD?
- Chronic cough
- Production of mucus
- Fatigue
- Shortness of breath
- Dyspnea
- Chest discomfort
What are the main causes of COPD?
- Chronic asthma
- Pollution
- Smoking (biggest cause)
- Age
- Chemical exposure
- Chronic bronchitis
- AAT deficiency
What are the main complications that can arise with COPD?
- Heart failure
- Acute respiratory distress syndrome
- Pneumonia
- Depression
- Frailty
What do categories ABC and D mean in the classification of COPD patients?
Patients classified by risk of exacerbation:
A - less symptoms low risk
B - more symptoms low risk
C - less symptoms High risk
D - more symptoms more risk
What were the main methods of COPD management in the NICE guidelines in 2018?
Non drug based:
Smoking cessation
Flu prevention
Pulmonary rehabilitation
Optimise treatment of co-morbidities
Summarise the management of COPD
- Smoking cessation
- Long acting bronchodilator
- Inhaled steroids? (<50% FEV)
- (Systemic steroids)
- Oxygen support
- Pulmonary rehabilitation therapy
Summarise the COPD exacerbation aetiology
i.e infectious/non infectious, factors, types of infections
20% non infectious:
- environmental factors
- non compliance with medications
80% infectious:
- Bacterial pathogens (40-50%)
- viral infection (30-40%)
- atypical bacteria (5-10%)
It is possible for COPD to progress to respiratory failure, describe types 1 and 2 of respiratory failure in COPD
Type 1 - alveolar effects (hypoxia)
- reduced surface area for gas exchange
- thickening of alveolar mucosal barrier
- often hyperventilate to compensate (pink puffer)
Type 2 - poor ventilation (CO2 retention and hypoxia)
- airway narrowing (reversible?)
- restrictive lung defects
Summarise types 1 and 2 of respiratory failure
Type 1:
- hypoxaemia (low oxygen)
- thickening of alveolar barrier
Type 2:
- hypercapnia
- ventilation failure
