Week 10 - COPD

Question 1

What does COPD stand for?

Answer 1

Chronic obstructive pulmonary disease

Question 2

COPD is impaired _____

Answer 2

ventilation

Question 3

What is COPD? (2)

Answer 3

• chronic, irreversible collection of lower airway disorders that interfere with airflow and gas exchange (emphysema and bronchitis)
• leads to inflammation, airway obstruction, and air trapping

Question 4

What is emphysema? (3)

Answer 4

• in alveolar tissue
• destructive problem of lung elastic tissue that reduces its ability to recoil after stretching, leading to hyperinflation of the lungs
• air is trapped in lungs

Question 5

What do enzymes do in emphysema? (2)

Answer 5

• Enzymes (proteases) destroy foreign particles from breathing
• Smoking stimulates synthesis of proteases, which damages alveoli and small airways by breaking down elastin

Question 6

What is chronic bronchitis? (3)

Answer 6

• airway issue
• inflammation of the bronchi and bronchioles caused by exposure to irritants (cigarette smoke)
• Irritants trigger inflammation, vasodilation, mucosal edema, cogestion, bronchospasms

Question 7

What does chronic bronchitis do to the mucus-secreting glands? (2)

Answer 7

• Chronic inflammation increases the number and size of mucus-secreting glands producing thick mucus
• Bronchial walls thicken and impair airflow

We get quicker breaths, and mucous blows O2 and CO2 from exchanging

Question 8

What is the etiology and genetic risk of COPD?

Answer 8

• Cigarette smoking
• Alpha 1-antitrypsin deficiency (AAT)
• Asthma: 12x greater

Question 9

What are the clinical manifestations of COPD in terms of respiration? (6)

Answer 9

• Chronic cough with excess sputum
• Rapid shallow respirations with abnormal breathing pattern
• Use of accessory muscles in abdomen or neck (high risk of cardiac arrest bc of exhaustion)
• Wheezes and abnormal sounds
• Dyspnea (SOB vs. SOBOE)
• Cyanotic, dusky appearance and excessive sputum production (chronic bronchitis)

Question 10

What are other clinical manifestations of COPD relating to other body systems? (5)

Answer 10

• Underweight with loss of muscle mass in the extremities/neck muscles enlarged
• Slow moving/fatigue
• Barrel Chest (1:1 rather than 1:1.5)
• Clubbing
• Psychosocial - Isolated, fearful and anxious

Question 11

What are the complications of COPD? (4, 7)

Answer 11

1. Exacerbations
   - increase in severity of disease with worsening clinical manifestations (often hospitalized)
   - Hypoxemia and acidosis, respiratory infection
2. Cardiac failure
   - Cor pulmonale (right sided failure from pulmonary disease)
3. Dysrhythmias
   - from hypoxemia, acidosis and cardiac disease
4. Respiratory failure

Question 12

What lab tests can we order to assess COPD? (5)

Answer 12

1. ABG - Hypoxemia and hypercapnia
2. Sputum samples - C&S
3. WBC - check for infection
4. CBC - Hgb and Hct (polycythemia - increase in all blood cells)
5. Elctrolytes - hyperkalemia

Question 13

What imaging do we order to assess COPD?

Answer 13

Chest xray to rule out other lung diseases or check prognosis with infections/chronic disease

Question 14

What other tests can we get to assess COPD?

Answer 14

PFT - for mild to severe
aka pulmonary function tests

Question 15

Flow chart on how COPD occurs

Answer 15