Simple COPD Flashcards
What is it?
Chronic obstructive airway disease that is characterised by its irreversibilty
2 underlying pathologies of COPD
Chronic bronchitis (in blue bloaters)
Emphysema (in pink puffers)
Remember BC and EP
Pathophysiology of Chronic Bronchitis
Chronic infection results in the chronic infiltration of the respiratory submucosa by inflammatory cells
This results in mucous gland hyperplasia and smooth muscle hypertrophy, causing bronchial lumen narrowing
Pathophysiology of Emphysema
Alveolar walls are destroyed resulting in bullae formation and the fusion of adjacent alveoli
This ultimately results in a decreased surface area for gas exchange and decreased elastic recoil with subsequent air trapping
Causes
GASES: Genetics Air pollution Smoking Exposure through occupation e.g. coal mining Secondhand smoke exposure
Example of genetic cause of COPD
Alpha-1 antitrypsin deficiency
Results in the loss of protection against proteases
Complications
CLIPPeR: Cor pulmonale Lung cancer Infections Pneumothorax Polycythaemia Respiratory failure
What is cor pulmonale
Right-sided heart failure due to chronic pulmonary hypertension
What type of antibiotics are used for infections that result from COPD
Macrolide antibiotics
How to confirm diagnosis of COPD
Spirometry:
FEV1 value <80% predicted
and
FEV1/FVC <0.7
Investigations of COPD
Spirometry CXR Bloods: FBC, U and Es, WCC, ESR, CRP, alpha-1 antitrypsin levels ECG Sputum culture
What would you see on a chest X-ray of COPD patient
Hyperinflation
Emphysematous change
Diaphragmatic flattening
Why would you take an ECG in COPD investiagtions
To check for cor pulmonale
How would you assess severity of COPD
GOLD scale: Stage 1 = mild COPD Stage 2 = moderate COPD Stage 3 = severe COPD Stage 4 = very severe COPD
*Treatment of COPD
ABCS, oxygen therapy, pulmonary rehabilitation: Anticholinergics e.g. ipratropium Bronchodilators e.g. salmeterol Corticosteroids Smoking cessation is imperative
Oxygen therapy
