COPD Exacerbation

Question 1

What is a COPD exacerbation?

Answer 1

Acute exacerbations of COPD may be defined as an acute worsening of respiratory symptoms (e.g., dyspnoea, cough, sputum production) that results in additional therapy. This worsening appears to result from increases in airway inflammatory cells and proteins that are triggered by an infection, airborne pollutants, and/or other factors.

Question 2

What are the risk factor for a COPD exacerbation?

Answer 2

• Bacterial infection
• GORD
• Viral infection
• Pollutants

Question 3

What are the symptoms of a COPD exacerbation?

Answer 3

• Dyspnoea
• Cough
• Incresaed sputum purulence and volume
• Wheeze
• Chest tightness
• Chest pain
  *

Question 4

What are the signs of a COPD exacerbation?

Answer 4

• Tachypnoea
• Tachycardia
• Signs of cor pulmonale

Question 5

How does COPD cause cor pulmonale? And how does cor pulmonale present?

Answer 5

Cor pulmonale may develop as a result of increased pulmonary artery hypoxaemic vasoconstriction due to exacerbation-induced hypoxaemia. The resulting increase in pulmonary vascular resistance and/or pulmonary artery pressure can lead to acute right heart failure.

Presents with peripheral oedema, elevated jugular venous pressure, hepatojugular reflux and systolic parasternal heave.

Question 6

What investigations should be ordered for a COPD exacerbation?

Answer 6

• ABG
• Pulse oximetry
• ECG
• FBC + platelets
• Electrolytes, urea and creatinine
• CRP
• CXR
• Sputum microscopy, culture and gram stain
• Vitamin D