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Respiratory > Management of COPD > Flashcards

Management of COPD Flashcards

1
Q

Which form of COPD is Airflow obstruction Hyperinflation?

A

Chronic Bronchitis

Emphysema

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2
Q

Is COPD reversible?

A

Not fully

Is progressive

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3
Q

What is the 3rd leading cause of death in the world?

A

COPD

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4
Q

How do you diagnose COPD?

A
  • Relevant History (Symptoms)
  • Look for clinical signs
  • Confirmation of diagnosis and assessment of severity
  • Other relevant tests
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5
Q

What are the different ways you can witness respiratory failure?

A
  • Tachypnea
  • Cyanosis
  • Use of accessory muscles
  • Pursed lip breathing
  • Peripheral Oedema
  • Ankle swelling, strain on right side of heart
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6
Q

What is the use of spirometry in COPD?

A

Confirms diagnosis and assesses severity

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7
Q

How do you analyse the results of a spiromtry to confirm COPD?

A
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8
Q

How do you assess the severity of COPD using FEV1/FVC?

A
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9
Q

What are the COPD baseline tests?

A

Spirometry - record absolute and % predicted value

CXR

ECG

FBC - Anaemic, polycthaemic, eosinophilia

BMI - weight, height

AIAT - Age of onset < 50

Anaemia can present as breathlessness

High blood cell count can be a sign of COPD

Polycthaemia = Increased RBC’s

AIAT is antitrypsin

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10
Q

LOOK

A
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11
Q

What are the different ways COPD is managed

A

Non-pharmacological

Pharmacological

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12
Q

What are the Non-pharmacological treatments

A
  • smoking cessation
  • vaccination (flu yearly + pneumococcal every 5 years)
  • pulmonary rehab
  • nutritional assessment
  • psychological support
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13
Q

What does pulmonary rehabilitation involve?

A
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14
Q

What are the benefits of Pulmonary Rehabilitation?

A
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15
Q

What are the ways you can manage COPD?

A

Prevention of disease progression

Releive breathlessness

Prevention of exacerbation

Management of complications

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16
Q

What is the interventions for the following aims

Prevention of disease progression

Releive breathlessness

Prevention of exacerbation

Management of complications

A
  • Smoking cessation
  • Inhalers
  • Inhalers, Vaccines, Pulmonary Rehabilitation
  • Long term Oxygen therapy
17
Q

What are the benefits of Pharmacological Management?

A
  • Relieve symptoms
  • Prevent exacerbations
  • Improve QoL
18
Q

What the pharmacological management for COPD with SOB

A
  1. SABA Salbutamol blue inhaler/Terbutaline
  2. SABA+LAMA
  3. SABA+LAMA/LABA (Salmeterol)
19
Q

What is the treatment for COPD with exacerbation

A
  1. SABA+LAMA
  2. SABA+LAMA/LABA
  3. SABA+LAMA/LABA/ICS
20
Q

What are the short acting bronchodilators used in inhaled therapy in COPD?

A
21
Q

What are the long acting bronchodilators used to treat COPD?

A
22
Q

What are examples of High dose inhaled corticosteroids (ICS and LABA)

A
23
Q

How does the COPD inhaler treatment progress with severity, symptoms and exacerbation?

A
24
Q

When is it appropriate to use Oxygen with a COPD patient

A

Hypoxia with:

PaO2< 7.3 kPa

PaO2 7.3-8 kPa if:

  • with second organ dysfunction
  • polycthaemia
  • nocturnal hypoxia
  • peripheral oedema
  • pulmonary hypertension
25
Q

What intervensions are used at different stages of COPD

A
26
Q

What are the symptoms of COPD exacerbation?

A

Increasing breathlessness

Cough

Sputum volume

Sputum purulence

Wheeze

Chest tightness

27
Q

What is the effect of AECOPD on alveoli and mucus glands (including goblet cells)?

A

Alveolar wall destruction and mucus hypersecretion

28
Q

What does management of AECOPD involve?

A
  • SA bronchodilators (salbutamol, ipratropium)
  • Change inhalers
  • Oral steroids (Prednisolone)
  • Antibiotics

Admit if

  • Tachypnoea
  • Low O2 < 90-92%
  • Hypotension
29
Q

What are the relevant AECOPD investigations?

A

FBC

Biochemistry of glucose

Theophyline concentration (in using theophyline)

ABS

ECG

CXR

Blood cultures in febrile patients

Sputum Microscopy

(ABS=Arterial blood gas)

30
Q

What are the different palliative care methods for COPD

A

Breathlessness/Dysfunctional breathing:

  • Pharmacological - Morphine
  • Psychological support
  • Palliative care referral

Respiratory (30 decks)

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