L2: COPD (Intro, Pathology, Causes, CP) Flashcards
Def of COPD
Other Def of COPD
COPD is a preventable disease and is a leading cause of morbidity and mortality
…
Types of COPD
Types of COPD
- Emphysema
Types of COPD
- Chronic Bronchitis
Pathophysiology Of COPD
RF for COPD
RF for COPD
- Environmental
RF for COPD
- Smoking
Smoking as a RF for COPD
- Significance
Smoking as a RF for COPD
- Types of Smoking
- Other type of tobacco (eg pipe, cigar, waterpipe) and marijuana are also risk factors
- Passive smoking also known as second hand smoke
- Smoking during pregnancy poses risk for the fetus
RF for COPD
- Biomass Exposure
RF for COPD
- Occupational Exposure
RF for COPD
- Air Pollution
- Outdoor air pollution: Dust, sandstorms and biomass fuel exposure
- Indoor air pollution: particularly in women
RF for COPD
- Genetic Factors
Mutation in SERPINA 1 gene lead to hereditary deficiency of alpha 1-antitrypsin (AATD)
RF for COPD
- Asthma & Airway Hypersensitivity
…
RF for COPD
- Infection
RF for COPD
- Gender
Women are more susceptible to the effects of tobacco smoke than men:
- As women exhibit smaller airway lumens and disproportionately thicker airway walls
Pathological Features of COPD
- Emphysema
- Chronic Bronchitis
Pathological Features of COPD
- Emphysema
Pathological Features of COPD
- Chronic Bronchitis
Mechansim of COPD
- Mucus Hypersecretion
- Small Airway Obstruction
- Protease/Antiprotease Imbalance
Mechansim of COPD
- Mucus Hypersecetion
Mechansim of COPD
- Small Airway Obstruction
Due to neutrophil infiltration because of release of chemotactic factors from macrophages.
Mechansim of COPD
- Protease-antiprotease Imbalance
CP of COPD
- Symptoms
- Signs
- Specific to Type
CP of COPD
- Symptoms
Symptoms of COPD
- Chronic Cough
Chronic Cough in COPD
- Significance
First symptoms of COPD
Chronic Cough in COPD
- Timing
At first: Present only on waking up
Later on: Cough occurs throughout the day (may be attributed by the patient to smoking “smoker’s cough”),
Chronic Cough in COPD
- Characters
May be dry or productive
Dyspnea in COPD
Dyspnea in COPD
- Significance
Cardinal symptoms of COPD
Dyspnea in COPD
- Course & Duration
- Chronic, progressive over time
- Persistent
Sputum in COPD
Sputum in COPD
- Characters
Chest Wheezes & Tightness in COPD
Usually persistent or continuous (not in attacks as bronchial asthma)
Fatigue in COPD
….
Additional Features in COPD
Signs of COPD
Signs of COPD
- Mild
No abnormality may be found.
Signs of COPD
- General
General Signs of COPD
- Attitude
Elevated shoulders with professorial attitude
General Signs of COPD
- Decubitus
Orthopnea
General Signs of COPD
- Vitals
- Increased respiratory rate (tachypnea)
- Puslus Paradoxus
General Signs of COPD
- Neck
- Congested neck veins may be seen on expiration.
- Prominent accessory respiratory muscles in neck.
- Indrawing of the suprasternal and supraclavicular fossae.
General Signs of COPD
- Abdomen
Abdominal protuberance may occur due to:
- low position of the flat diaphragm with forward displacement of the abdominal contents
General Signs of COPD
- Lips & Muscles
- Expiratory pursed lip breathing.
- Generalized muscle wasting in advanced cases.
Local Examination in COPD
Local Examination in COPD
- Inspection & Palpation
Local Examination in COPD
- Percusiion
Local Examination in COPD
- Auscultation
Symptoms & signs of respiratory failure or corpulmonale with RSHF
May Be Present
blue bloater type of COPD patient may also have
The pink puffer type of COPD patient may also have
- Clubbing is ….. a feature of COPD and suggests ……
- Not
- malignancy, bronchiectasis or other type of lung diseases
