COPD Flashcards

(30 cards)

1
Q

What is the key difference between asthma and COPD?

A

Asthma is fully reversible obstruction whereas COPD is not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the FEV1/FVC in patients with COPD?

A

Always less than 0.7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

COPD is graded in it’s severity by what?

A

FEV1 starting at mild which is grade 1 which is less than 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is grade 2 COPD

A

Moderate with an FEV1 of 50-79%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is stage 3

A

Severe and there is a FEV of 30-49%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the 4th and final grade

A

Very severe accompanies an FEV1 of >30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

COPD is an umbrella for which two diseases?

A

Chronic bronchitis and emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What other factors differentiate COPD from asthma?

A

COPD patients: over 35, persistent and productive cough, almost always caused by smoking, breathlessness progressive and persistant, no nocturnal symptoms unless severe, FMH uncommon, atopic co-conditions less likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When can COPD appear at earlier ages?

A

In hereditary alpha 1 antitrypsin deficiency. (It is normally responsible for protecting connective tissue breakdown by neutrophil elastase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the main pathological features of COPD?

A

Mucous hyperseceretion, tissue destruction, impaired repair and defence mechanisms causing small airway inflammation and fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does the fibrosis and inflammation of the small airways lead to?

A

Increased resistance, reduced compliance, air trapping and progressive airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is emphysema?

A

Histologically enlarged air spaces distal to terminal bronchioles and destruction of alveolar walls reducing total surface area of the lungs for exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is chronic bronchitis?

A

Cough and sputum production on most days of 3 months of a year for at least 2 consecutive years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Prevalence of COPD?

A

10-20% of over 40s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are pink puffers? (Emphysema patients)

A

Patients with high alveolar ventilation, near normal PO2, normal or low PCO2, they are breathless but not cyanosed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What might pink puffers progress to?

A

Type 1 respiratory failure where there is hypoxia (PaO2 of

17
Q

What are blue bloaters? (Chronic bronchitis)

A

Hypoxia, hypercapnic, high resp rate, raised Hb, oedema, cardiomegaly, use of accessory breathing muscles progresses to type 2 respiratory failure

18
Q

With emphysema patients especially, (low PCO2) means breathing is driven by hypoxia therefore what should you be careful doing?

A

Giving oxygen as it may cause respiratory arrest

19
Q

What are the signs of COPD?

A

Tachypnoea, use of accessory muscles, hyperinflation, decreased circosternal space, quiet breath sounds, cyanosis, cor pulmonale.

20
Q

What is cor pulmonale

A

Right ventricular dilatation and consequent fluid retention as a result of increased resistance for blood entering the pulmonary circulation increasing after load

21
Q

What investigations must be done?

A

Spirometry, ABGs, CXR, FBC (showing increased PCV and haemocrit of >55%), echocardiogram to confirm RV dilatation in cor pulomonale

22
Q

What lifestyle advice and general help would you give to those with chronic COPD?

A

Smoking cessation, weight loss, influenza and pneumococcal vaccination,

23
Q

What drug might you give as a general measure if required?

A

Short acting beta agonist and ipratropium bromide

24
Q

If moderate give what?

A

Long acting anti-muscarinic (tiotropium) or beta 2 agonist

25
If severe give what?
Long acting beta agonist and corticosteroid
26
If the patient remains symptomatic after grade 3 treatment do what?
Give tiotropium, inhaled steroid, beta agonist and refer to specialist
27
Non smokers can receive what if symptoms persist and PO2 below 7.4
Long term oxygen therapy (LTOT)
28
Complications of COPD
Exacerbations, polycythemia, respiratory failure, cor pulmonale, pneumothorax, carcinoma
29
General steps for exacerbation of COPD are?
Nebulised bronchodilators, controlled O2 therapy aiming 88-92%, antibiotics, steroids
30
COPD is characterized by what?
Airway obstruction with little or NO REVERSIBILITY