Plenary

Question 1

What are causes of breathlessness

Answer 1

asthma
COPD
pneumonia
lung cancer?
interstitial lung disease

Question 2

What are cardiovascular causes of breathlessness

Answer 2

Heart failure: pulmonary oedema
Pulmonary embolism
Atrial fibrillation

Question 3

Other causes of breathlessness

Answer 3

Pneumothorax
Panic attack
foreign bodies

Question 4

Alerting symptoms of a cough

Answer 4

COugh>3 weeks
History of smoking associated with haemoptysis
A change in ‘smoker’s cough’ is a serious alerting symptom

Question 5

What are normal O2 sats for a patient with COPD

Answer 5

88-92%

Question 6

How does COPD affect FEV1

Answer 6

reduces it

Question 7

Management of COPD?

Answer 7

• stopping smoking
• vaccinations ie influenza and pneumococcal
• Self management plan
• Pulmonary rehabilitation
• Assess co-morbidities ie heart, bone, mental health

Question 8

First line of treatment for a COPD patient

Answer 8

Short acting beta 2 agonist or short acting antimuscarinic

Question 9

Second line of treatment for a COPD patient if FEV1> 50%

Answer 9

Add a long acting beta 2 agonist or long acting antimuscarinic

Question 10

Second line of treatment for a COPD patient if FEV1<50%

Answer 10

Add long acting beta 2 agonist and inhaled steroid

or

replace SA antimuscarinic with long acting antiM

Question 11

Third line of treatment if the second line of treatment isn’t working as the disease progresses

Answer 11

Long acting antimuscarinic
PLUS
long acting beta 2 agonist
PLUS
inhaled steroid

Question 12

Tests useful in the diagnosis of COPD

Answer 12

FVC
FEV1
FEV1/FEVC
PEF
EGFR
haemoglobin
Haematocrit
MCV
White Cell count
C-reactive protein