CPOD

Question 1

COPD
Pathophysiology

Answer 1

COPD is a term used to encompass chronic inflammatory and destructive diseases within the lungs, including chronic bronchitis, asthma, and emphysema. The symptoms of COPD are not completely reversible, and many patients with COPD are short of breath even when they are well. It is most commonly seen in patients who have been long term smokers or have had some industrial exposure to substances that damage the lungs.

• An umbrella term of emphysema, chronic bronchitis and chronic asthma
• COPD is typically caused by long term smoking, other causes include long term exposure to pollution such as fine dusts
• COPD cannot be cured, however management plans can be put in place to slow it’s progression
• Target Sp02 level for COPD patients is between 88%-92%, nebuliser bronchodilators are used to relieve exacerbation symptoms

Question 2

COPD
Management plan

Question 3

COPD
Clinical features

Answer 3

Clinical Features

Chronic Bronchitis

Subtle onset in the persons 50s or 60s.
Fatigue.
Intolerance to exercise.
Cough.
Sputum production.
Shortness of breath.
Reduced amount of oxygen reaching the bloodstream results in cyanosis.
Cor pulmonale may occur, resulting in systemic oedema.
Often referred to as ‘blue bloaters’.2
Emphysema

Marked dyspnoea.
Intolerance to exercise.
The collapse of the bronchioles at the beginning of expiration, trapping air and causing hyperinflation.
Breathing through pursed lips – this increases back pressure in the lungs, splinting the alveoli and helping with expiration.
Hyperinflation over time alters the shape of the chest (making it deeper that is broad), often described as ‘barrel-chested’.
Often referred to as ‘pink puffers’.2
Asthma

Wheeze.
Shortness of breath.
Intolerance to exercise.
Excess mucous production