COPD - Chronic Obstructive Pulmonary Disease

Question 1

What is COPD?

Answer 1

COPD is the construction of the airway sacs through progressive, persistent airflow limitation caused by damage and inflammation

Question 2

What are the two causes of COPD?

Answer 2

Emphysema and Chronic bronchitis

Question 3

What is the biggest etiological factor of COPD?

Answer 3

Smoking

Question 4

What is emphysema?

Answer 4

Emphysema is the loss of the wall of the alveoli and it’s elasticity. This reduces the transfer of substances causing shortness of breath.

Question 5

What is Chronic Bronchitis?

Answer 5

Chronic bronchitis effects the bronchial tubes. Chronic inflammation occurs in the the tube, swelling and causing production of phlegm. To remove the phlegm coughing is the only resolution.

Question 6

What is the pathophysiology of COPD?

Answer 6

Chemoreceptors respond to chemical stimuli, CO2 in the blood for example. Therefore they regulate breathing. The body doesn’t realise COPD patients are being starved of oxygen as a result of the reduction of chemoreceptor sensitivity. They have a reduced respiratory drive causing hypoxia. You get a large head ache. Those patients do not get this so do not know that they are suffering with a lack of oxygen. COPD patients struggle to breath out and have a fluid build up the drive becomes lazy so you only breath in the upper part of the chest. POTS patients have COPD like symptoms but the effects are reversible
After the headache you get a build up of carbon dioxide and retention and hypoxia. When you become hypoxic the blood becomes thick and syrup like which run the risk of clot formation.

Question 7

What happens to Alpha-1 antitrypsin in normal patients and deficient COPD patients?

Answer 7

Normal - protects lungs from neutrophil elastase
Deficient - Lungs lack alpha-1 antitrypsin coating, leaving them pen to damage by neutrophil elastase. Alpha-1 gets trapped in the liver causing liver damage.

Question 8

What happens to neutrophil elastase in normal patients and CPD patients?

Answer 8

Normal - Produced by white blood cells to break down harmful bacteria. Potentially damaging to lungs if exposed.
Deficient - Uninhibited, causing lung damage

Question 9

Compare Chronic Bronchitis and Emphysema?

Answer 9

Chronic Bronchitis;

• Overweight and Cyanotic (blue skin)
• Elevated haemoglobin level
• Peripheral oedema
• Rhonchi and wheezing

Emphysema;

• Older and thinner
• Severe dyspnea (difficulty breathing)
• Quiet chest

Question 10

Staging of disease severity

Answer 10

Stage 0 - At risk - cough and sputum 
Stage 1 - Mild - FEV1 >80%
Stage 2 - Moderate - FEV1 <50% >80%
Stage 3 - Severe - FEV1 <30% >50%
Stage 4 - Very Severe - FEV1 <30%