Management of COPD COPY 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

Is progressive

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3
Q

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

A

COPD

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4
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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5
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, strain on right side of heart
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6
Q

What is the use of spirometry in COPD?

A

Confirms diagnosis and assesses severity

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7
Q

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

A
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8
Q

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

A
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9
Q

What are the COPD baseline tests?

A

Spirometry - record absolute and % predicted value

CXR

ECG

FBC - Anaemic, polycthaemic, eosinophilia

BMI - weight, height

AIAT - Age of onset < 50

Anaemia can present as breathlessness

High blood cell count can be a sign of COPD

Polycthaemia = Increased RBC’s

AIAT is antitrypsin

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10
Q

LOOK

A
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11
Q

What are the different ways COPD is managed

A

Non-pharmacological

Pharmacological

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12
Q

What are the Non-pharmacological treatments

A
  • smoking cessation
  • vaccination (flu yearly + pneumococcal every 5 years)
  • pulmonary rehab
  • nutritional assessment
  • psychological support
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13
Q

What does pulmonary rehabilitation involve?

A
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14
Q

What are the benefits of Pulmonary Rehabilitation?

A
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15
Q

What are the ways you can manage COPD?

A

Prevention of disease progression

Releive breathlessness

Prevention of exacerbation

Management of complications

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16
Q

What is the interventions for the following aims

Prevention of disease progression

Releive breathlessness

Prevention of exacerbation

Management of complications

A
  • Smoking cessation
  • Inhalers
  • Inhalers, Vaccines, Pulmonary Rehabilitation
  • Long term Oxygen therapy
17
Q

What are the benefits of Pharmacological Management?

A
  • Relieve symptoms
  • Prevent exacerbations
  • Improve QoL
18
Q

What the pharmacological management for COPD with SOB

A
  1. SABA Salbutamol blue inhaler/Terbutaline
  2. SABA+LAMA
  3. SABA+LAMA/LABA (Salmeterol)
19
Q

What is the treatment for COPD with exacerbation

A
  1. SABA+LAMA
  2. SABA+LAMA/LABA
  3. SABA+LAMA/LABA/ICS
20
Q

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

21
Q

What are the long acting bronchodilators used to treat COPD?

A

– Relieve symptoms
– Prevent exacerbations – Improve quality of life

22
Q

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

23
Q

How does the COPD inhaler treatment progress with severity, symptoms and exacerbation?

24
Q

When is it appropriate to use Oxygen with a COPD patient

A

Hypoxia with:

PaO2< 7.3 kPa

PaO2 7.3-8 kPa if:

  • with second organ dysfunction
  • polycthaemia
  • nocturnal hypoxia
  • peripheral oedema
  • pulmonary hypertension
25
What intervensions are used at different stages of COPD
26
What are the symptoms of COPD exacerbation?
Increasing breathlessness Cough Sputum volume Sputum purulence Wheeze Chest tightness
27
What is the effect of AECOPD on alveoli and mucus glands (including goblet cells)?
Alveolar wall destruction and mucus hypersecretion
28
What does management of AECOPD involve?
* SA bronchodilators (salbutamol, ipratropium) * Change inhalers * Oral steroids (Prednisolone) * Antibiotics Admit if * Tachypnoea * Low O2 \< 90-92% * Hypotension
29
What are the relevant AECOPD investigations?
FBC Biochemistry of glucose Theophyline concentration (in using theophyline concentration) ABS ECG Chest X-Ray Blood cultures in febrile patients Sputum Microscopy
30
What are the different palliative care methods for COPD
Breathlessness/Dysfunctional breathing Pharmacological - Morphine Psychological support Palliative care referral