Management of COPD Flashcards
What kind of disease is COPD?
Airflow obstruction disease
Example of a specific airflow obstruction disease 1
Chronic bronchitis - thick mucous blocks airways, inflammation and swelling further narrows airways
What happens to the FEV1:FVC ratio in chronic bronchitis?
Airways permanently obstructed so FEV1:FVC <70%
Example of a specific airflow obstruction disease 2
Emphysema - alveoli hyper inflated, air gets trapped, gas exchange hard because alveolar walls damaged
3 features of COPD
Airflow obstruction
Progressive
Not fully reversible
Risk factors of COPD
Mainly smoking but others include occupation, infection, air pollution
What is AECOPD (acute exacerbation of chronic obstructive pulmonary disease)?
When a patient with COPD experiences a sustained (e.g. 24-48hrs) increase in symptoms (cough, sputum, dyspnoea, wheeze)
Symptoms of COPD
Dyspnoea, cough, recurrent chest infection
FEV1:FVC ratios - normal, restrictive/obstructive lung disease
Normal >80%
Restrictive <80%
Obstructive <70%
How to assess severity of acute COPD
FEV1: ≥ 80% predicted (mild severity) 50-79% predicted (moderate severity) 30-49% predicted (severe) < 30% predicted (very severe)
Investigations used to diagnose COPD
Take clinical history - relevant symptoms
Physical examination
Spirometer test (confirms diagnosis, assesses severity)
Other baseline tests for COPD other than spirometry
Chest x-ray
ECG
FBC - too see if anaemic
Features of a COPD patient
Age >35, productive persistent cough, likely to smoke, persistent breathlessness, uncommon to have nocturnal symptoms, uncommon to have family history of COPD, may have eczema
Features of an asthma patient
Any age, sporadic dry cough, may/may not smoke, sporadic variable breathlessness, nocturnal symptoms common, family history common, eczema common
Classes of drugs in obstructive lung diseases asthma and COPD)
Short acting/long acting bronchodilators
High dose inhaled corticosteroids + long acting bronchodilators combo
