Management of COPD

Question 1

What is the definition of COPD

Answer 1

obstructive chronic bronchitis and/or emphysema

Question 2

what are some symptoms in COPD

Answer 2

breathless
cough
recurrent chest infection

Question 3

COPD is not a respiratory disease alone what other adverse health problems can it cause

Answer 3

loss of muscle mass
weight loss
cardiac disease
depression/anxiety

Question 4

how many people does COPD affect in the UK

Answer 4

I million patients in the UK

Question 5

Globally what is the effect of COPD

Answer 5

2020 it will be the 3rd leading cause of death

Question 6

what symptoms would cause you to suspect COPD

Answer 6

current or former smoker 
chronic cough
breathlessness
sputum production
frequent "winter" Bronchitis
wheeze/ chest tightness

Question 7

on examination of a patient with COPD what signs may you find that confirm the diagnosis

Answer 7

reduced chest expansion
hyperinflated chest
wheeze

Question 8

on examination of a patient with COPD what respiratory failure signs may be present

Answer 8

Tachypneoa
Cyanosis
Use of accessory muscles
Pursed lip breathing
Peripheral Oedema

Question 9

what is spirometry

Answer 9

test that measures how much air you can breathe out in one forced breathe

Question 10

what are COPD tests

Answer 10

spiromerty 
CXR
ECG
full blood count
BMI-weight loss in COPD

Question 11

if a patients is suspected to have COPD but is under 50 what could the cause be

Answer 11

alpha-1 antitrypsin deficiency

chronic asthma

Question 12

what are treatment options that can help manage COPD

Answer 12

stop smoking
inhalers
long term O2 therapy
vaccines - stop infections

Question 13

what are two short acting bronchodilators

Answer 13

SABA (eg- Salbutamol)

SAMA (eg- Ipratropium

Question 14

what are two long acting bronchodilators

Answer 14

LAMA eg- Tiotropium

LABA eg- Salmeterol

Question 15

what are two high dose inhaled corticosteroids and LABA

Answer 15

Relvar (Fluticasone/vilanterol)

Symbicort

Question 16

what are the benefits of pulmonary rehabilitation

Answer 16

improves exercise capacity
reduced feeling of breathlessneess
reduced anxiety and depression associated with COPD
enhances effects of LABA (dilators)

Question 17

when would a patient receive long term oxygen therapy as part of their treatment for COPD

Answer 17

if they had a value of PaO2 lower than 7.3kPa

or

indications of sever disease like polycythaemia, nocturnal hypoxia, peripheral oedema, pulmonary hypertension

Question 18

how would you manage a patient with AECOPD as an outpatient

Answer 18

Short acting bronchodilators
steroids
antibiotics if they have infection
consider hospital admission if they are unwell

Question 19

if a patient with AECOPD is admitted to hospital what investigations would you do

Answer 19

FBC
arterial blood gas
ECG
CXR
blood cultures in ferbile patients 
sputum culture

Question 20

how would you manage a AECOPD patient that has been admitted

Answer 20

give oxygen 
nebulised bronchodilators
corticosteroids
antibiotics
asses for evidence of respiratory failure