MP324 - COPD

Question 1

what is COPD

Answer 1

chronic obstructive pulmonary disease

chronic slowly progressive disorder characterised by airflow obstruction

Question 2

pathological features of COPD

Answer 2

• glandular hypertrophy, reduced number of cilia
• goblet cell metaplasia; smooth muscle hypertrophy; fibrosis
• loss of alveolar fine structure

Question 3

physiological consequences of COPD

Answer 3

• increased cough +/- sputum
• increased mucus production, increased expiratory flow resistance
• loss of lung recoil, reduced gas exchange

Question 4

symptoms of COPD

Answer 4

• cough with/without sputum
• dyspnoea (SOB)
• wheeze

Question 5

2 clinical phenotypes of COPD

Answer 5

chronic bronchitis
emphysema

Question 6

clinical diagnosis of chronic bronchitis

Answer 6

daily productive cough for 3 months ore more, in at least 2 consecutive years

Question 7

clinical diagnosis of emphysema

Answer 7

permanent enlargement and destruction of airspaces distal to the terminal bronchiole

Question 8

3 types of chronic bronchitis

Answer 8

simple mucoid bronchitis
mucopurulent (pus) bronchitis
chronic obstructive bronchitis

Question 9

clinical manifestations of chronic bronchitis

Answer 9

• hypersecretion of mucus by goblet cells
• bronchospasm, dyspnoea and wheezing
• hypoxia and hypercapnia (elevated CO2)
• productive cough
• increased body weight

Question 10

a complication of chronic bronchitis

Answer 10

cor-pulmonale (right-sided HF)

Question 11

emphysema

Answer 11

an abnormal permanent enlargement of large spaces distal to the terminal bronchioles, accompanied by destruction of their walls

Question 12

clinical manifestations of emphysema

Answer 12

• loss of intricate alveolar structure
• small highly effective gas-exchanging units into large, inefficient cyst-like spaces
• larger volumes of gas need to be inhaled to meet metabolic needs
• severe difficulty breathing

Question 13

effect of emphysema on oxygen and carbon dioxide levels

Answer 13

chronic respiratory failure
low blood oxygen levels (hypoxemia) and elevated levels of carbon dioxide (hypercapnia, hypercarbia, chronic respiratory acidosis)

Question 14

symptoms of chronic bronchitis

Answer 14

• recurrent productive cough
• hypoxic/hypercapnia
• cyanotic
• increased RR
• Ronchi and wheezing
• cardiac enlargement

Question 15

symptoms of emphysema

Answer 15

• dyspnoea
• increased CO2 retention
• pink complexion (hyperventilation)
• minima cyanosis
• pursed lips breathing
• barrel chest
• thin (loss of appetite, muscle wasting)

Question 16

BODE index

Answer 16

predicts disease severity in COPD

Question 17

4 predictors of BODE index

Answer 17

• body mass index (BMI)
• degree of airflow obstruction assessed by FEV1
• mMRC dyspnoea scale
• exercise 6MWD test