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 It is also preogressive

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3
Q

What are the symptoms of COPD?

A

Breathlessness Cough Recurrent Chest infection (frequent ‘winter bronchitis) Sputum productions Wheeze/Chest tightness Usually in people aged 35 and older

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4
Q

Why do people develop COPD?

A

Reactive oxygen species Cause tissue damage and deactivate antiproteases (increase in neutrophil elastase) more tissue damage

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5
Q

What are the other health effects of COPD?

A

Loss of muscle mass - TNF interleukin affected - less drive to eat food Exercise ability is very poor Weight Loss Cardiac disease Depression, anxiety etc

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6
Q

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

A

COPD

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7
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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8
Q

What are the clinical differences between COPD and ASTHMA? Use the headings: Age, Cough, Smoking, breathlessness, nocturnal symptoms, family history, concomitant eczema or allergic rhinitis

A
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9
Q

What are the examinations for COPD?

A

No diagnostic tests

May be normal in early stages

Reduced chest expansion

Prolonged expiration/Wheeze

Hyperinflated chest

Respiratory failure

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10
Q

What are the different ways you can witness respiratory failure?

A

• Tachypneoa

  • Cyanosis
  • Use of accessory muscles
  • Pursed lip breathing
  • Peripheral Oedema

Ankle swelling too, because lots of strain on the right side of the heart

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11
Q

What is the use of spirometry in COPD?

A

COnfirms diagnosis and assesses severity

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12
Q

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

A
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13
Q

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

A
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14
Q

What are the COPD baseline tests?

A

Anaemia can present itslef as breathlessness

HIgh blood cell count can be a sign of COPD

Polycthaemic means lots of RBC’s

AIAT is antitrypsin

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15
Q

LOOK

A
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16
Q

What are the ways you can manage COPD?

A

Prevention of disease progression

Releive breathlessness

Prevention of exacerbation

Management of complications

17
Q

What is the interventions for the following aims?

Prevention of disease progression

Releive breathlessness

Prevention of exacerbation

Management of complications

A

Prevention of disease progression - Smoking cessation

Releive breathlessness - Inhalers

Prevention of exacerbation - Inhalers, Vasccines, Pulmonary Rehabilitation

Management of complications - Long term Oxygen therapy

18
Q

What vaccines can help prevent exacerbation?

A

– Annual Flu vaccine

– Pneumococcal vaccine

19
Q

What is the non-pharmacological management of COPD?

20
Q

What does pulmonary rehabilitation involve?

21
Q

What are the benefits of Pulmonary Rehabilitation?

22
Q

What are the benefits of Pharmacological Management?

A

– Relieve symptoms
– Prevent exacerbations

– Improve quality of life

23
Q

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

24
Q

What are the long acting bronchodilators used to treat COPD?

A

– Relieve symptoms
– Prevent exacerbations – Improve quality of life

25
What are examples of High dose inhaled corticosteroids (ICS and LABA)
26
How does the COPD inhaler treatment progress with severity, symptoms and exacerbation?
27
What is QALY?
A measurement used to measure one year of good quality life
28
What are the most expensive treatment methods for COPD per QALY?
29
Who benefits from long term oxygen therapy?
People who are hypoxic to the point of
30
LOOK
31
What are the symptoms of COPD exacerbation?
32
What is the effect of AECOPD on alveoli and mucus glands (including goblet cells)?
Alveolar wall destruction and mucus hypersecretion
33
What does management of AECOPD involve?
Short acting bronchodilators (salbutamol/ipratropium/nebulisers) Steroids (Prednisolone 40mg per day for 5-7 days) Antibiotics (only if there is evidence of infection: Fever, increase in volume/purulence of sputum) Hospital admission if unwell (tachypnea, low oxygen saturation (below 90-92 %)Hypotension.
34
What are the relevant AECOPD investigations?
Full blood count Biochemistry of glucose Theophyline concentration (in patients using theophyline concentration) Arterial blood gas Electrocardiograph Chest X-Ray Blood cultures in febrile patients Sputum Microscopy, culture and sensitivity