Management of COPD

Question 1

COPD

Answer 1

Chronic obstructive pulmonary dsease
Airway lining swells up
Airway muscles tighten
Mucous builds up

Question 2

Airflow obstruction

Answer 2

Chronic brochitis

Not fully reversible

Question 3

Hyperinflation

Answer 3

Emphysema

Question 4

Symptoms of COPD

Answer 4

Non specific -
Breathlessness
Cough
Recurrent chest infection

Question 5

Breathlessness

Answer 5

At gas exchange level

Abnormal diaphragm function - can’t take deep breaths

Question 6

Cough and recurrent chest infection

Answer 6

Cilia mechanism damaged - secretions go between cilia and prevent movement

Question 7

Causes of COPD

Answer 7

Neutrophil elastase released due to nicotine - damages tissues

Question 8

Weight loss

Answer 8

Rapid breathing - energy required

Question 9

COPD diagnosis

Answer 9

Relevant history - breathlessness, cough and recurrent chest infections + smoker + over 35
Sputum production
Spirometry normal in initial stages
Clinical signs later - CXR to exclude other conditions

Question 10

COPD examination

Answer 10

Reduced chest expansion
Prolonged expiration/wheeze
Hyperinflated chest
Spirometry - confirms diagnosis, assess severity

Question 11

Short acting bronchodilators

Answer 11

SABA (short acting B2 agonist) eg salbutamol

SAMA (short acting muscarinic agonist) eg ipatropium

Question 12

Long acting bronchodilators

Answer 12

LABA (long acting B2 agonist)

LAMA (long acting muscarinic antagonist)

Question 13

High dose inhaled corticosteroids

Answer 13

ICS - relvar, fostair MDI

Question 14

Inhaled medications

Answer 14

Short acting bronchodilators
Long acting bronchodilators
High dose inhaled corticosteroids