COPD clinical features and treatment Flashcards
is copd reversible
no
what effect does emphyseam have on alveoi
damages surface making it less able to pass air
separates alveli
what is the effect on broncitis
increased about of mucous and inflamed broncail tube wall
what is prevalce
no of peopl in population with the condition each year
what is incidence
no. of new people with the disease over a set period
what gender does copd mainly effect
males
what occupations are most at risk from copd
ariculte, brick making, mining, constuction, dock workers, flour and grain workers in the food industry, petroleum works, rubber, plastics,stone masonry
are larger or smaller lungs more supeiclbe to copd
smaller
what are common causes of copd
chroinc bronchitis, lower social eachion status, asthma, childhood infection
elastase
released by neutiophils in lungs in repsoe to chemical from cigarette smoke
what is teh functino of aat
alpha 1 antitrypisin is a protese inhibtroy proded by the liver and reduces the damage of cigarette smoke, some people can have deficies in it
what other disdse can a lack of aat cause
liver fibrois or cirrhosis
what percent of smokers deveolp copd during their lifetime if they smoke for more than 25 years
25
what is the fletcher peto curve
descibres that your fev can still stop declig at accelerated rate at any point if you stop smoking, you will never get your lost fev back
what are commonsymtons of copd
couggh, breathlessness, sputum, wheezing ( bronchoitis), frequent chest infections,
what are other symptons of copd
weight loss ( emysema) , fatique and swolen ankles (in bronchitis), use of expresity musles
what effect can smoking during pregnacy have on the child
feotal lung growth and primingy of immune system
what is jvp and is it seen more in
raised jugular pressure
what is teh mmrc breathlessness scale
puts someone on the scale of how easily they become breathlessnes, where the 0 is most people, ( strenough exercise) and the 4 is not able to leave house due to being breathlessness
what are the 4 level of spiromy for copd
1 - mild - fev` above 80%
2- moderate - fev
3 - severe - fev 30- 40
four. v. severe - fev less than 30
what features of a chest x ray are seen with a patient with copd
vascular hilda enlarged , hyper inflatoin of lungs, bulla (empysema) , small heart, flat diaphram
do copd symptons cahnge ever
no generaly same throgh day and night, can be worse with flair ups
what age is copd normaly common
when aged over 35 years
what is the level of kco and dl like in copd
the retention of kco is reduced in copd due reduced surface area of alveoi
what may be seen in hrct
in high resolution computer tomocgrutoin , may see :
lung cysts,
signets rigns signs
traction bronchiectasis
centriobular emphysesam
honey combing
what symptons should you admit someone with copd exacerbations to hospital
severe breathlessnes, poor general condition, cynanois, confined to bed, oedeam worseing, imared consciousness, acute confusion, rapid rate of onset, co morbilties, sa02 less than 90
what could cause exerbations
viral infections, pneothaors, trama
what tests canbe done in hospitals for copd parties who are admitted with exacerbations
crx (genetic test), blood gases, fbc, uand e (urea and electrolites) , sputum culture, vts (phycological test)
what is the treatment for copd in hospital
nebuliser bronchodilator (b2 and anti muscarinic), oxygen, oral /iv cortiocstiod and antibitions
what could hand flapping when upright mean
reduced 02 and posible increaesd co2
what is cor pulmonary
increase in size of the right side o the heart as a result of severe copd
what is secondary polycythaemia
over production of erthoyctes and hameoglobing,
what is the consequces of polycythaemia
increased blood viscoisty
what are clincal feautes of cor pulmonale
tachycardica, oedematous, rasied jvp, congested liver, right axis devaiotn, p pulmonale, t wave inversio, pulmonary hypertension, triuspin reguritation
what is generl criteria for bronchtis
chough of 3 moths or more for 2 years
what are typical symptons of emyseam and typical symptoms of bronitoiits
emyseam- queiet cheest, severe dysteam, thin, flatedn diathran and hyper inflated lungs on x-ray
Bronchioitis - overweight, elevated haemoglobin, periphealed edema, wheezing
what does pulonary hypertenio cuase
decreased output of left side of heart due to reduced blood flow to the area
main non pharmolical managmets of copd
smoking cessation
vaccinations
pulmonary rehab
nutritional assesments
psychological support
exercise totlerece,
nutrietion
what vaccines are best for copd
flu, pneuococcal
what are saba
short acting beta agonists e.g. salbutamol
what are sama
short acting muscalinic antagonisti (e.g. ipratroium)
what are lama
long acting anti muscaling agents e.g. umeclidium and tioprium
what are laba
long acting beta agonists e..g salmeterol
what are high does corticosteriods
relvar e..g fluticasone and vilanterol
and fostair e..g mdi
what is teh first steps for premodily breathlessnes
saba
then lama
then
lama + laba
what are teh steps for copd with exacerbations and breathlessnes
saba and lama
then laba as wel
then ics on top
what are the criteria for long term oxygne
long term oxygne pa02 less than 57 mm hg unlss you are polycyateic, nocutral hypotex, peripah uldema or pulpuor hypertension than it is less than 60 mm hg
what steriods can be used for copd
prednisolne
what medication is used for pallitive care
morphine
