COPD (Chronic Obstructive Pulmonary Disease) Flashcards
What are the main signs/symptoms of COPD?
Breathlessness
Cough
(Can have sputum produced, probably will as chronic broncheitis requires suputum to be produced)
What is COPD clincally?
It is chronic broncheitis and emphysema.
A patient can also have elements of asthma or can also be diagnosed with asthma.
What is the aetiology of COPD?
Smoking
Air pollution
Alpha antitrypsin deficiney (this can be a cause of emphysema, so could contribute to COPD)
(occupational causes)
Flour and grains
Dust (construction workers, quarry workers ect)
What happens to FEV1/FVC in COPD?
It is reduced and will gradually reduced further over time.
Even though lung function decrease with time normally the gap between normal and COPD results will increase.
What other things contibute to the development of COPD/ are risk factors?
Being from a lower socioeconomic status
Asthma/airway hyper-reactivity
Chronic bronchitis
Childhood infection
What kind of COPD is more likely to have and alpha-1 antitrypsin deficiency invovled in it?
Early onset COPD
Give some data/infomation that tells of the link between smoking and COPD?
~50% of smokers develop COPD
There is a greater COPD mortality rate in smokers than in non-smokers.
What common symptoms may be present at an inital presentation of COPD?
SOB recurrent chest infections Ongoing cough Wheeze Productive cough/ sputum
What are some less common symptoms that patients may present with at an inital COPD presentation?
Weight loss Fatigue Decrease exercise tolerance Ankle swelling Cor Pulmonale
What symptoms may a patient present with if they are having an exacerbation of their COPD?
Cyanosis Raised JVP (jugular venous pressure) Cachexia (a profound and marked state of constitutional disorder) Wheeze Pursed lip breathing Hyperinflated chest Use of accessory muscles Peripheral oedema
What is the scaled used to measure breathlessness (Dyspnoea)?
mMRC breathlesssness scale
0= only get breathless with strenuous exercise
1=SOB when hurrying on level ground or when walking up a slight hill
2=SOB when walking on level ground, has to walk slower than people of the same age due to breathlessness, has to stop for breath when walking at own pace.
3= SOB after walking 100 yards or after a few mins on level ground
4=too breathless to leave the house or breathless when dressing
What are particular areas of interest in a COPD history?
How long the symptoms have been going on for?
Age of the person (above 35 years old)
Smoking history
What investigations are used to diagnose COPD?
No single diagnostic test
A combination of symptoms, history and spirometry is needed for a diagnosis.
What are some of the criteria needed for a COPD diagnosis?
- Typical symptoms
- > 35 years old
- Presence of risk factor (smoking or occupational exposure)
- Absence of clinical features of asthma
- Air flow obstruction confirmed by post-bronchodilator spirometry.
What spirometry results must you get?
FEV1/FVC <0.7 post bronchodilator, as this demonastrates a lack of reversibility (so not asthma)
