W2: MC (Part 2) Flashcards
COPD is characterised by:
Persistent respiratory symptoms and airflow limitation
In 2022 COPD was the …… leading cause of total disease burden in Australia. What percentage of all deaths?
4th leading cause
4.1%
COPD is an obstructive or restrictive disease?
Obstructive
(Due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases)
In COPD the most common respiratory symptoms include:
Dyspnoea
Cough
Sputum production
What age group has the highest percentage of COPD patients?
- Men
- Age 65-74 & 75 +
List 5 risk factors for COPD
- Tobacco smoke: cigarette & passive smoking
- Indoor air pollution
- Occupational exposures: dusts & chemical agents, fumes
- Outdoor air pollution
- Genetic factors
- Age and gender
- Lung growth and development
- Socioeconomic status
- Asthma and airway hyper-reactivity
- Chronic bronchitis
- Infections
Key indicators for considering a diagnosis of COPD?
- Dyspnea that is progressive over time, characteristically worse with exercise, persistent
- Chronic cough
- Chronic sputum production
- Recurrent lower respiratory tract infections
- History of risk factors eg tobacco smoke, vapors, fumes, gases
- Family history of COPD and/or childhood factors eg low birth weight, childhood respiratory infections
Clinical features of COPD? (6)
- Barrel chest
- Accessory muscle use
- Decreased breath sounds on ausculation
- Oxygen desaturation
- Hyperinflation on chest radiograph
- Reduced functional exercise capacity
COPD: barrel chest
Where the antero-posterior diameter of the chest wall is enlarged (like a barrel) due to hyperinflation.
COPD: accessory muscle use
Particularly the inspiratory accessory muscles, e.g. sternomastoid, pectoralis major and minor, serratus anterior, latissimus dorsi and trapezius
COPD: decreased breath sounds on ausculation due to…? What are you likely to hear if their is sputum in the airways?
Due to loss of alveoli and hyperinflation. There may be coarse crackles if sputum is present in the airways.
COPD: oxygen desaturation - when is this commonly reduced? And what is the normal range for COPD patients?
Decreased saturation during exercise and in severe cases, oxygen saturation may be also low at rest (88-92% is common)
COPD: hyperinflation on chest radiograph - key indications? 5*
- Increased radiotranslucency (i.e. dark lung fields)
- Loss of peripheral lung markings
- Rib position more horizontal
- Elongated mediastinum with narrow heart shadow
- Diaphragm intersects 11th or 12th rib posteriorly.
COPD: reduced functional exercise capacity - how is this measured?
Measured by a reduced distance walked in either the 6-minute walk test or incremental shuttle walk test compared to predicted.
In normal presentations of healthy individuals, the thorax or chest has a greater …… diameter than …… diameter. However, in a barrel chest, the individual has a wider AP diameter, making their chest look over …… (COPD)
Transverse than AP
Inflated
In COPD as the chest is filled with excess air, the diaphragm and ribs lose their normal curvature, taking on a …… appearance. The diaphragm normally has a dome like appearance, but it becomes quite flat, causing blunting of the ……. angle (where the ….. and …… meet). The lung fields also appear quite ….. and there is a loss of lung …….
Flattened
Costophrenic
Diaphragm & Ribs
Dark
Markings
What is spirometry?
A respiratory function test to diagnose COPD & identify severity of the condition. Involves maximal forced expiratory maneuvers.
The criteria for COPD diagnosis is based on….What do these values indicate?
FEV1/FVC of <0.7 (70% of predicted after bronchodilator medication)
- FVC is the amount of air that can be forcibly expired during a maximal expiration.
- FEV1 is the amount of air expired during the first second of that maximal expiration.
