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Respiratory system SA > Management of COPD > Flashcards

Management of COPD Flashcards

1
Q

What causes airflow obstruction in COPD

A

chronic bronchitis

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2
Q

What causes the hyperinflamation in COPD

A

emphysema

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3
Q

What causes the mucous build up and what does this rest in

A

Goblet cells - block the airways and reduce air flow

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4
Q

What is the main difference between COPD and asthma

A

COPD is irreversible

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5
Q

What is the affect of emphysema

A

alveoli walls loose elasticity (damaged)

trap air

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6
Q

What is the symptoms of COPD

A

Breathlessness - due to airway obstruction

Cough (recurrent chest infection)

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7
Q

What is the further problems caused by the affects and living with COPD

A

Loss of muscle mass -exercise capacity bad
Weight loss
cardiac disease - puts a strain on the heart
depression/anxiety

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8
Q

How is hyperinflation caused by COPD

A

the loss of elasticity causes the chest wall to recoil and push out, also the alveoli wall gas exchange cause the diaphragm to be pushed down

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9
Q

How is COPD diagnosed

A

Relevant clinical history
Examination - Clinical signs
Spirometry Tests - confirm

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10
Q

What is the signs and relevant history for COPD

A 
– Chronic Cough
– Exertional Breathlessness
– Sputum production
– Frequent “Winter” Bronchitis 
– Wheeze / chest tightness
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11
Q

What are signs of COPD upon examination

A

reduced chest exspansion
Listen to hear wheeze
Hyperinflated chest
Signs of respiratory failure

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12
Q

What are signs of respiratory failure

A
  • Tachypneoa - rapid breathing
  • Cyanosis - discoloured skin due to deoxygenation
  • Use of accessory muscles
  • Pursed lip breathing
  • Peripheral Oedema - swelling in ankles
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13
Q

What do spirometry test allow

A

To confirm diagnosis

asses severity

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14
Q

What does spirometry measure

A

The FEV1/FVC

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15
Q

What value on the spirometry test predicts COPD to be extremely severe

A

<30%

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16
Q

What base line test are carried out in the diagnosis of COPD

A 
ECG - check the heart
Xray - check hyperinflation  
• Full blood count 
• BMI - weight (kg)/height
• AIAT- If age of onset < 50 years
Sputum microscopy
17
Q

Why is a full blood count measured

A

As anaemia can also cause breathlessnes - rule out other possibilities

18
Q

What two things does spirometry measure

A

records absolute and predicted value

19
Q

What is the aims in the management of COPD

A

improve quality of life
prevent progressiveness
manage complications

20
Q

What intervention prevents worsening of COPD

A

stop smoking - cant reverse but will stop progression

21
Q

What is examples of non pharmaceutical management

A 
Flu vaccinations - as are more prone 
Stop smoking 
Pulmonary Rehabilitation
Nutritional assessment
Psychological support
22
Q

Why is Psychological support useful?

A

panic of not being able to breath makes you breath less, therefore you need to overcome this

23
Q

What is pulmonary rehabilitation

A

Support and uses exercise and nutrition to improve health

24
Q

What is the benefits of pharmacological management

A

– Relieve symptoms
– Prevent exacerbations
– Improve quality of life

25
Q

What is the three different version of inhaler therapy

A

Short acing bronchiodilators
Long acting bronchiodilators
High dose inhaled corticosteroids (ICS) and LABA

26
Q

What is examples of Short acing bronchiodilators

A

– SABA (eg- Salbutamol)

– SAMA (eg- Ipratropium)

27
Q

What is the two types of Long acting bronchiodilators

A

Long acting anti – muscarinic agents ( Umeclidinium, Tioptropium)
Long acting B2 agonist (Salmeterol)

28
Q

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

A

– Relvar (Fluticasone/vilanterol)

– Fostair MDI

29
Q

What is the conditions if triple therapy is required in treating COPD

A

worsening FEV1

Increasing symptoms and exasperation

30
Q

Why is a Flue vaccinations offered to those patients with COPD

A

As are more prone to the FLU

31
Q

When is on term oxygen therapy offered in relation to COPD

A 
Patients with hypoxia PaO2 <7.3kPa
Or have the following conditions:
polycythaemia 
nocturnal hypoxia
peripheral oedema 
pulmonary hypertension
32
Q

What are the symptoms of COPD exasperation

A 
• Increasing breathlessness 
• Cough
• Sputum volume
• Sputum purulence • Wheeze
• Chest tightness
33
Q

How is COPD exasperation managed

A

Short acting bronchodilators
Steriods
Antibiotics
Hospital admission

34
Q

What are example of when hospital admission would be considered

A

– Tachypneoa
– Low Oxygen saturation (< 90-92%)
– Hypotension

35
Q

What steroids are used for COPD exasperation

A

Prednisolone 40 mg per day for 5-7 days

36
Q

What do you use for acute respiratory failure

A

Non – Invasive ventilation (NIV)

Respiratory system SA (37 decks)

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