MSRA: COPD Flashcards
What is the management of an acute exacerbation of COPD?
Oxygen
Nebulised bronchodilators
Steroids
Consider antibiotics
Consider NIV if retain or acidotic despite optimised medical management
What is the benefit of ICS in COPD?
To reduce the frequency of exacerbations
What are the indications for long-term oxygen therapy?
pO2 less than 7.3
OR
pO2 less than 8 with polycythaemia, raised JVP or peripheral oedema
What are the investigations for COPD?
Spirometry
CXR
FBC
What is the criteria for pulmonary rehabilitation?
MRC 3+
What are the steps in management of COPD?
First line = SABA or SAMA
If ongoing symptoms:
- If asthmatic features: LABA and ICS
- If no asthmatic features: LABA and LAMA
What is the most common cause of infective exacerbations of COPD?
Haemophilus influenza
What are the first line antibiotics for an infective exacerbation of COPD?
Amoxicillin or Doxy or Clarithromycin
What antibiotic is used for prophylaxis in COPD?
Azithromycin
What are the indications for prophylactic antibiotics in COPD?
Do not smoke
Optimised inhaler therapy
and frequent/prolonged exacerbations or hospitalisation
What are the asthmatic features/features suggestive of steroid responsiveness to consider in a patient with COPD?
Previous diagnosis of asthma or atopy
Diurnal variation
Raised eosinophils
Which interventions have been shown to increase survival in patients with COPD?
Stop smoking
LTOT in hypoxic patients
What is the inheritance pattern of alpha-1 antitrypsin deficiency?
Autosomal recessive
