Pulmonary - COPD Flashcards
What is COPD?
What is the mechanism? - A picture
deterioration of small airways because of the chronic inflammation
How is the gas exchange of COPD?
mismatched perfusion @ capillary membrane = hypoxemia
How does hypoxemia progress to?
hypercapnia (increased CO2 in the arterial blood) = pulmonary hypertension
The progression of COPD contributes to what?
Decreased O2 in arterial blood
What are the possible causes of COPD?
- loss of elastic recoil = collapsed airway (air trap)
- walls between alveoli are destroyed and dilation of alveolar spaces
- increased compliance of lung tissue
- more mucus = clogged airways
- normal exhalation = thorax returned to resting position
What does the closed airway contribute to?
cyclic hyperinflation = thorax can’t go back to resting position
What is the prevalence of COPD?
- 3rd leading cause of death
- 4th leading cause of death in the U.S in general
- 1 in 5 have COPD
- 16 milly+
- gets lots of ER visits
What is the general demographics of COPD?
- over 40 with increased age around 65-75
- women more than men
- smoking (duh)
- lower income
- unemployed, retired and disable
- increased risk in SE and MW regions
- rural areas more likely
What is the most common cause of COPD regarding demographics?
Smoking (80%)
never smoked (10-25%)
Poor air quality
What are the risk factors of COPD?
occupational exposure
exposure to air pollution
age
cigarette smoking
childhood respiratory conditions
genetics
What are the important components for the patient hx?
- former/current smoker
- exposure to passive smoking
- environmental exposures
- occupational dusts and chemicals
- hx of childhood respiratory conditions
- older age
- family hx
- SOB with activity
What is the common clinical presentation?
- most common sx = dyspnea
- chronic cough
- barrel chest
- wheezing
- reduced or absent breath sounds
- retain CO2
For dyspnea - usually with exertional activities / worsens over time and becomes apparent with lower-level ADL
COPD testing
What does spirometry measure for pulmonary function testing?
time-volume relationships in the lungs
The gold standard
COPD testing
Obstructive disease is characterized by?
Delay and incomplete emptying of the lung during exhalation which would benefit from testing to diagnose
COPD PFT
What is the process of PFT-spirometry?
Two forced expiratory volumes monitored are forced expiratory volume in 1-sec and forced vital capacity
FEV1/FVC ratio = >75% is normal
What is the classifications of COPD severity?
mild = add short-acting bronchodilator
mod = add long-acting brochodilator + rehab
severe = add inhaled corticosteroids
very severe = add O2 if respiratory failure (possible surgical options)
What is the grades of breathlessness?
What is emphysema?
condition of the lung where the alveolar walls are destroyed and enlargement of airspaces distal to terminal bronchioles
Chronic bronchitis
Where does hypersecretion start?
starts at large airways and goes to smaller airways = hypertrophy of submucosal glands
Appearance of emphysema vs chronic bronchitis
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