Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory Medicine > COPD > Flashcards

COPD Flashcards

1
Q

What is COPD?

A
  • Airway obstruction which is progressive and not fully reversible.
  • It includes chronic bronchitis and emphysema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the predominant cause of COPD?

A

Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is an endogenous cause of COPD? How does it cause the disease?

A

Alpha-1-antitrypsin deficiency - This is a protease inhibitor which suppresses enzymes which breaks down proteins. It presents with panacinar emphysema and cirrhosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some other causes of COPD?

A

Endogenous - IgA deficiency, primary ciliary dyskinesis

Exogenous - Air pollution, illicit drug use, recurrent pulmonary infections, TB, chronic exposure to dust

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the pathophysiology of COPD?

A
  1. Chronic inflammation - Increased neutrophils, macrophages and T lymphocytes. This results in:
    - Goblet cell proliferation, mucus hypersecretion, impaired ciliary function
    - Fibrosis
    - Smooth muscle hyperplasia of small airways and pulmonary vasculature, leading to pulmonary hypertension
  2. Parenchymal dysfunction
    - Destruction of alveolar walls and elastic tissue
    - Decreased elastic recoil and increased compliance
    - Air trapping and hyperinflation
  3. Imbalance of oxidants/anti-oxidants and overabundance of free radicals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is the airway obstructed in COPD?

A
  1. Luminal obstruction by secretions
  2. Narrowing of small bronchioles as less radial traction by elastin in the surrounding alveoli
  3. Less elastic recoil so air trapping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a ‘pink puffer’?

A
  • A typical COPD patient, who has increased alveolar ventilation, a near normal pO2 and normal/low pCO2. - They are breathless but not cyanosed.
  • They will likely progress to type I respiratory failure
  • Emphysema end of the COPD spectrum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a ‘blue bloater’?

A
  • A typical COPD patient, who has decreased alveolar ventilation and a low pO2 and a high pCO2.
  • They are cyanosed but not breathless and may go on to develop cor pulmonale.
  • Their respiratory centres are relatively insensitive to CO2 and rely on hypoxic drive to maintain respiratory oxygen.
  • Chronic bronchitis end of the COPD spectrum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some symptoms of COPD?

A

Cough
Sputum
Wheeze
Dyspnoea - Initially worse on exercise and then progresses over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some signs of COPD?

A 
Tachypnoea
Use of accessory muscles of respiration
Hyperinflation
Decreased cricosternal distance (<3cm)
Reduced chest expansion
Resonant or hyperresonant percussion
Quiet breath sounds 
Wheeze
Cyanosis 
Cor pulmonale
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you investigate for COPD?

A
  1. Bloods - Increased PCV as erythrocytosis secondary to chronic hypoxia
  2. CXR
  3. CT
  4. ECG
  5. aBG
  6. Spirometry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What would a CXR show in COPD?

A
  • Hyperinflation
  • Flat hemidiaphragms
  • Large central pulmonary arteries
  • Decreased peripheral vascular markings
  • Bullae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What would a CT show in COPD?

A
  • Bronchial wall thickening
  • Scarring
  • Air space enlargement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would an ECG show in advanced COPD?

A

Right atrial and venticular hypertrophy (cor pulmonale)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What would an aBG show in COPD?

A

Decreased pO2 and hypercapnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What would spirometry show in COPD?

A
  • An obstructive pattern and air trapping
    FEV1<80% of predicted, FEV1:FVC ratio <70%
    Increased TLC, increased RV, decreased DLCO
17
Q

What are some lifestyle changes you can implement for patients with COPD?

A 
Smoking cessation
Encourage exercise
Correct BMI with diet advice and supplements 
Screen for depression
Flu and pneumococcal vaccines
18
Q

How might a patient present with an acute exacerbation of COPD?

A

Increasing cough, breathlessness, wheeze, decreased exercise capacity

19
Q

What investigations should be done in acute exacerbation of COPD?

A

Bloods - aBG, FBC, U+E, CRP, blood cultures if pyrexic
CXR - Exclude pneumothorax and infection
ECG
Send sputum for culture if purulent

20
Q

What is the treatment for acute exacerbation of COPD?

A
  1. O2 via a fixed performance face mask due to risk of CO2 retention. Aim for sats 88-92%. Start at 24-28% O2. Adjust according to aBG.
  2. Nebulised salbutamol 5mg/4hr and ipratropium 500micrograms/6hr
  3. Steroids - Oral prednisolone 30mg START, then OD for 7 days. IV 200mg hydrocortisone if cant do PO.
  4. Antibiotics - If evidence of infection. Amoxicillin 500mg/8hr PO.
  5. Physiotherapy to aid sputum expectoration.
21
Q

What should be added if there is no initial response to the treatment of acute exacerbation of COPD?

A

IV aminophylline

22
Q

If there is no response after adding aminophylline, what do you do to treat acute exacerbation of COPD?

A
  1. Consider NIV if type 2 resp failure and pH 7.25-7.35
  2. Consider a respiratory stimulant drug eg doxapram if unsuitable for ventilation.
  3. If pH<7.25 - consider ITU referral

Respiratory Medicine (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions