CPRS Case 6: COPD Flashcards
Physiology of breathing and ventilation
See physiology practical + lecture
Etiological mechanism and pathogenesis of COPD
See lecture
Pathophysiology of chronic airflow obstruction and its relationship to symptoms and clinical examination findings
See lecture
Cardiovascular complications and metabolic features of chronic airflow obstruction
Acute: (severe asthma attack / COPD exacerbation)
- pneumothorax
- pulmonary infections
- respiratory failure (Type 2)
Chronic complications: (mostly COPD)
- Cor pulmonale
- Increased RBC —> increased blood viscosity —> venous thrombosis
Interpret simple lung function indices and investigations results related to chronic airflow obstruction and respiratory failure
See physiology practical 1
Principles of acute and long term management of chronic airflow obstruction including drug therapy, lifestyle and behavioural factors
See lecture on respiratory pharmacology
Lifestyle:
- Smoking cessation
- Exercise
- Diet management
- Personal hygiene
Other long term treatment
- Palliative care
- Hypoxaemia: Oxygen therapy
- Hypercapnia: Ventilatory support (Noninvasive positive pressure ventilation NPPV)
- Vaccine
—> influenza vaccine
—> Pneumococcal vaccine (polysaccharide, conjugate)
Explain to COPD patient why it is important to quit smoking
See lecture
Comobidities:
- Lung cancer
- CVD
- Osteoporosis
- Depression/anxiety
- OSA
- Gastroesophageal reflux (GERD)
Community importance of smoking-related illness and identify groups at risk
- Increase health care burden
- Decreased productivity due to ill health
- Excess risk from
1. Exposure to spouse
2. Workplace exposure
Public health approaches to reduce smoking-related illness
MPOWER
Role of doctors in helping patients quit smoking
5As:
- Ask: identify all tobacco users
- Advice: all users to quit
- Assess: willingness and rationale of quitting
- Assist: quit plan
- Arrange: follow-up contact
AWARD model:
- Ask: history of smoking
- Warn
- Advice
- Refer
- Do it again
