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Resp > Lecture 16 - COPD > Flashcards

Lecture 16 - COPD Flashcards

1
Q

COPD

A

Emphysema and chronic bronchitis

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2
Q

Cause of COPD

A

Smoking 90%

Alpha 1 antitrypsin deficiency

Air pollution

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3
Q

Type of respiratory deficiency

A

Obstructive

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4
Q

Pathophysiology

A

Airways:

  • chronic inflammation
  • fibrosis
  • increased airway resistance as narrowed
  • Obstructed by mucus oedema
  • ciliary dysfunction

Lungs:

  • Decreased elastic recoil
  • Decreased radial traction - bronchoconstriction
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5
Q

Chronic bronchitis

A
  1. Enlargement of mucus secreting glands and increased goblet cells replacing ciliated resp epithelium
  2. Ciliary dysfunction therefore decreased mucous clearance
  3. Mucus obstructs airway and get airway inflammation
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6
Q

Emphysema

A
  1. Breakdown of elastin in alveolar walls
  2. Decreased elastic recoil causes large air spaces with air trapping.
    - decreased radial traction
    - hyperinflation
  3. Decreased SA to volume ration decreases gas exchange
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7
Q

Effects of COPD

A

Hypoxia - pulmonary vasocontriction - thickening of smooth muscle

Cor pulmonale

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8
Q

Symptoms of COPD

A

Chronic productive cough
Wheeze
Persistant dyspnea - SOBOE

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9
Q

RF of COPD

A

Smoking
FHx
Occupational dust
Pollution

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10
Q

Investigations

A

Spirometry - Obstructive

  • scalloping
  • Reduced FEV1
  • Reduced FEV1/FVC below 70%
  • not reversed with bronchodilator

CXR - Barrel chest
Percussion - hyper resonant

ABG

Blood test - alpha 1 antitrypsin deficiency - in younger patients with COPD

Breath sounds - wheeze

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11
Q

Signs of COPD

A

Using accessory muscles to breath

Prolonged expiration phase

Tachypnoea

Central cyanosis

Flapping tremors

Wheeze

Cor pulmonale:

  • raised JVP
  • peripheral oedema
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12
Q

Grading of dyspnoea

A

1 - breathless with exercise

2 - breathless when walking up slight hill

3 breathless when walking a distance

  1. breathless when walking short distances

5 - can’t leave house. breathless when dressing

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13
Q

Exacerbation

A

Atleast 1 major and minor symptom

Acute worsening of respiratory symptoms that requires additional therapy

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14
Q

Management

A
  1. Monitor hypoxia and hypercapnia via ABG and pulse oximeter
  2. Antibiotics against haemophilus influenzae and streptococcus pneumoniae
  3. Corticosteroid - prednisolone (eisinophilic inflammation)
  4. O2 therapy - sats 88%- 94%
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15
Q

RF for exacerbation

A

Frequent exacerbation

Airflow obstruction

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16
Q

Treatment

A

Relieve dyspnoea
Improve exercise tolerance
Prevent exacerbations

  • pulmonary rehab
  • bronchodilators
  • smoking cessation
  • oxygen therapy
  • corticosteroids
  • macrolides
17
Q

Oxygen therapy

A

Minimum 16 hours/day

Resp (22 decks)

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