COPD vs Asthma Flashcards
What is a wheeze
continuous, coarse, whistling sound produced in the respiratory airways during breathing. Some part of the respiratory tree must be narrowed or obstructed
How does a COPD patient present
Pack year hx of smoking, persistent dyspnea, cough, sputum
How does asthma typically present
atopy, allergic rhinitis, intermittent cough and a wheeze
what features does asthma have
wheezing, breathlessness, chest tightness, night time/early morning coughing
what are the 3 cardinal features of asthma
variability, PRECIPATANTS, reversibility
Is asthma familial
Yes
Allergic asthma has what cells involved
eosinophils, mast cells, IgE
what tests can be used to diagnose asthma
simple peak flow, vitalograph, spirometry
what do you normally want to see on spirometry
Rapid upstroke and a long expiration
How does COPD present
hypoxia because of emphysema (blue bloaters) and then chronic coughing and mucus production because of chronic bronchitis (pink puffers)
what is COPD
persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious gasses
What is classified as a significant bronchodilator response on spirometry
20% improvement in peak flow or 12% and 200ml improvement in FEV1
Does asthma or COPD show more of bronchodilator response
asthma
Are steroids used early or late in COPD guidelines
Late
what are advantages of inhaled therapy
targets site of disease, lower dose, limited systemic absorption, fewer side effects, rapid onset
what are the goals for asthma therapy
symptom control and risk reduction (minimize risk of future exacerbations)
what type of medications are more commonly used for COPD but should never be used alone in asthma
LABA
what are the goals for COPD therapy
limit disease progression by stopping smoking
Improve lung mechanics by treating symptoms
prevent exacerbations by treating critical periods of symptomatic deterioration
Improve quality of life and function by rehab
what are the key elements of COPD therapy
education
reduce symptoms by relieving symptoms and improving exercise tolerance
reducing risk by preventing disease progression
what are the non-pharmacological treatments for COPD
smoking cessation
promote healthy lifestyle
vaccination
treat comorbidities
what vaccinations reduces risk of copd
influenza and pneumococcal
what drugs should be given to patients who can keep up with their friends (MMRC<2)
short acting beta-2 agonist or anticholinergic
what drugs must you give to patients who cannot keep up with their friends (MMRC>3)
LABA or long acting muscarinic antagonist
Why are COPD patients typically older
You need a significant pack year hx of smoking
How does asthma and copd differ in terms of persistent symptoms
Asthma has variation and COPD is continous
How does asthma and copd differ in terms of worsening of symptoms
asthma is seasonal and it is triggered by emotions and other exposures and nocturnal whilst COPD has a progressive course
what are the primary treatment options for COPD
bronchodilators
Typical spirometry stracing
