Resp Medicine - COPD Flashcards
chronic bronchitis definition
-productive cough on most days for at least 3 months for at least two consecutive years
emphysema definition
-abnormal and permanent enlargement of the airways distal to the terminal bronchiole
pink puffer =
purse lipped breathing & thin (emphysema)
blue bloater =
cyanotic and barrel chest (bronchitis)
Diagnostic tests for COPD?
Spirometry
- FEV1/FEV < 70
- reduced FEV1
- no or partial reversibility
imaging for COPD?
CXRAY - hyperinflation
CT Thorax - may see emphasematous bulla, bronchial wall thickening, air trapping, airway enlargment
appearance of hyperinflated lungs on cXRAY?
> 6 anterior ribs visible at midclavicular line or flattened hemidiaphrams
blood tests for COPD?
-FBC
-CRP
-IgE and RAST - rule out asthma
-A1AT if suspected
-immunoglobulins for immunodeficiency
-
what micro test should you do for COPD?
sputum culture
test to check for cor pulmonale wiht COPD?
echo, BNP, ECG
what is the GOLD score used for?
symptom/exacerbation assessment used to guide management
GOLD A treatment
SABA or SAMA
GOLD B treatment
LABA or LAMA
GOLD C treatment
LAMA
GOLD D treatment
LAMA or
LAMA + LABA or
LABA + ICS
what is the DECAF score for?
-score used to predict mortality in patients with COPD exacerbation in hopsital
DECAF SCORE parameters
D - dysnpea E- eosinophilia C- consolidation on CXRAY A - acidemia < 7.3 F - fibrillation
how to interpret the DECAF score?
0-1 = low mortality 2-6 = high mortality
what is the BODE score for?
-predicts 4 year survival in patients with COPD
BODE score parameters
B- BMI
O- airflow obstruction (FEV1)
D- dyspnea
E- exercise capacity (6 min walk test)
indications for long term oxygen therapy?
- if PaO2 < 7.3
- if PaO2 < 8 AND evidence of pulmonary HTN
how many hours a day should LTOT be used for?
15 +
what is ipatroprium?
Short acting antimuscarinic
what is tiotropium?
Long acting antimuscarinic
