COPD clinical features and treatment

Question 1

is copd reversible

Answer 1

no

Question 2

what effect does emphyseam have on alveoi

Answer 2

damages surface making it less able to pass air
separates alveli

Question 3

what is the effect on broncitis

Answer 3

increased about of mucous and inflamed broncail tube wall

Question 4

what is prevalce

Answer 4

no of peopl in population with the condition each year

Question 5

what is incidence

Answer 5

no. of new people with the disease over a set period

Question 6

what gender does copd mainly effect

Answer 6

males

Question 7

what occupations are most at risk from copd

Answer 7

ariculte, brick making, mining, constuction, dock workers, flour and grain workers in the food industry, petroleum works, rubber, plastics,stone masonry

Question 8

are larger or smaller lungs more supeiclbe to copd

Answer 8

smaller

Question 9

what are common causes of copd

Answer 9

chroinc bronchitis, lower social eachion status, asthma, childhood infection

Question 10

elastase

Answer 10

released by neutiophils in lungs in repsoe to chemical from cigarette smoke

Question 11

what is teh functino of aat

Answer 11

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

Question 12

what other disdse can a lack of aat cause

Answer 12

liver fibrois or cirrhosis

Question 13

what percent of smokers deveolp copd during their lifetime if they smoke for more than 25 years

Answer 13

25

Question 14

what is the fletcher peto curve

Answer 14

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

Question 15

what are commonsymtons of copd

Answer 15

couggh, breathlessness, sputum, wheezing ( bronchoitis), frequent chest infections,

Question 16

what are other symptons of copd

Answer 16

weight loss ( emysema) , fatique and swolen ankles (in bronchitis), use of expresity musles

Question 17

what effect can smoking during pregnacy have on the child

Answer 17

feotal lung growth and primingy of immune system

Question 18

what is jvp and is it seen more in

Answer 18

raised jugular pressure

Question 19

what is teh mmrc breathlessness scale

Answer 19

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

Question 20

what are the 4 level of spiromy for copd

Answer 20

1 - mild - fev` above 80%
2- moderate - fev
3 - severe - fev 30- 40
four. v. severe - fev less than 30

Question 21

what features of a chest x ray are seen with a patient with copd

Answer 21

vascular hilda enlarged , hyper inflatoin of lungs, bulla (empysema) , small heart, flat diaphram

Question 22

do copd symptons cahnge ever

Answer 22

no generaly same throgh day and night, can be worse with flair ups

Question 23

what age is copd normaly common

Answer 23

when aged over 35 years

Question 24

what is the level of kco and dl like in copd

Answer 24

the retention of kco is reduced in copd due reduced surface area of alveoi

Question 25

what may be seen in hrct

Answer 25

in high resolution computer tomocgrutoin , may see :
lung cysts,
signets rigns signs
traction bronchiectasis
centriobular emphysesam
honey combing

Question 26

what symptons should you admit someone with copd exacerbations to hospital

Answer 26

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

Question 27

what could cause exerbations

Answer 27

viral infections, pneothaors, trama

Question 28

what tests canbe done in hospitals for copd parties who are admitted with exacerbations

Answer 28

crx (genetic test), blood gases, fbc, uand e (urea and electrolites) , sputum culture, vts (phycological test)

Question 29

what is the treatment for copd in hospital

Answer 29

nebuliser bronchodilator (b2 and anti muscarinic), oxygen, oral /iv cortiocstiod and antibitions

Question 30

what could hand flapping when upright mean

Answer 30

reduced 02 and posible increaesd co2

Question 31

what is cor pulmonary

Answer 31

increase in size of the right side o the heart as a result of severe copd

Question 32

what is secondary polycythaemia

Answer 32

over production of erthoyctes and hameoglobing,

Question 33

what is the consequces of polycythaemia

Answer 33

increased blood viscoisty

Question 34

what are clincal feautes of cor pulmonale

Answer 34

tachycardica, oedematous, rasied jvp, congested liver, right axis devaiotn, p pulmonale, t wave inversio, pulmonary hypertension, triuspin reguritation

Question 35

what is generl criteria for bronchtis

Answer 35

chough of 3 moths or more for 2 years

Question 36

what are typical symptons of emyseam and typical symptoms of bronitoiits

Answer 36

emyseam- queiet cheest, severe dysteam, thin, flatedn diathran and hyper inflated lungs on x-ray
Bronchioitis - overweight, elevated haemoglobin, periphealed edema, wheezing

Question 37

what does pulonary hypertenio cuase

Answer 37

decreased output of left side of heart due to reduced blood flow to the area

Question 38

main non pharmolical managmets of copd

Answer 38

smoking cessation
vaccinations
pulmonary rehab
nutritional assesments
psychological support
exercise totlerece,
nutrietion

Question 39

what vaccines are best for copd

Answer 39

flu, pneuococcal

Question 40

what are saba

Answer 40

short acting beta agonists e.g. salbutamol

Question 41

what are sama

Answer 41

short acting muscalinic antagonisti (e.g. ipratroium)

Question 42

what are lama

Answer 42

long acting anti muscaling agents e.g. umeclidium and tioprium

Question 43

what are laba

Answer 43

long acting beta agonists e..g salmeterol

Question 44

what are high does corticosteriods

Answer 44

relvar e..g fluticasone and vilanterol
and fostair e..g mdi

Question 45

what is teh first steps for premodily breathlessnes

Answer 45

saba
then lama
then
lama + laba

Question 46

what are teh steps for copd with exacerbations and breathlessnes

Answer 46

saba and lama
then laba as wel
then ics on top

Question 47

what are the criteria for long term oxygne

Answer 47

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

Question 48

what steriods can be used for copd

Answer 48

prednisolne

Question 49

what medication is used for pallitive care

Answer 49

morphine