Infective Exac Copd

Question 1

Most common pathogens causing infective exacerbation of COPD ?

Answer 1

bacteria :
Haemophilus influenzae (most common cause)
Streptococcus pneumoniae
Moraxella catarrhalis

30 % virus
Human rhinovirus

Question 2

Clinical features of Inf exacerbation of COPD

Question 3

Hospital admission of COPD needed when ?

Answer 3

severe breathlessness

acute confusion or impaired consciousness

cyanosis

oxygen saturation less than 90% on pulse oximetry.

social reasons e.g. inability to cope at home (or living alone)

significant comorbidity (such as cardiac disease or insulin-dependent diabetes)

Question 4

X

Question 5

X

Question 6

Management of INFECTIVE EXAC of COPD ?

Answer 6

Oxygen therapy
4L/ min 28 percent Venturi mask target 88-92 %

Regular nebulisers

IV hydrocort may be considered rather than prednisolone for 5 days

IV theophylline if not responding to nebulisers

======

They recommend giving oral antibiotics ‘if sputum is purulent or there are clinical signs of pneumonia’

Question 7

When do we use NIV

Answer 7

typically used for COPD with respiratory acidosis pH 7.25-7.35 usually (PH < 7.3)

rising pCO2 PaCO2>6kPa

or a respiratory rate >30

Question 8

Intubation and ventilation is considered when

Answer 8

Ph < 7.25

Question 9

First line antibiotic management for INF EXAC?

Answer 9

amoxicillin or clarithromycin or doxycycline.