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OSCE Conditions > COPD > Flashcards

Flashcards in COPD Deck (10):
1

Signs of COPD

Expiratory wheeze
Tachypnoea
Use of accessory muscles
Pursed lip breathing
Barrel chest

Severe: cyanosis, raised JVP, CO2 retention tremor, cor pulmonale

2

Causes of COPD

Smoking
Alpha-1-antitrypsin deficiency
Occupational exposure - coal dust, pollution

3

Define COPD

Chronic airflow obstruction, slowly progressing, not fully reversible, does not change markedly over several months

4

Symptoms of COPD

Productive cough (white sputum)
Wheeze
Breathlessness

5

Pathophysiology of COPD

Emphysema: destruction of terminal bronchioles and alveoli leads to impaired gas exchange. Destruction of supporting tissue decreases radial traction and means the small airways close in expiration, leading to airway obstruction.

Bronchitis: chronic inflammation of the large airways leads to mucus hypersecretion and airway remodelling and narrowing.

6

Investigations of COPD

CXR - hyperinflated lungs (over 7 anterior ribs in lung field and flattening of the diaphragm)
Spirometry - FEV1/FVC ratio <70%
FBC - anaemia
Blood gas - low pO2, high pCO2
Alpha-1-antitrypsin
MRC Dyspnoea score

7

Management of COPD

Smoking cessation, pulmonary rehabilitation

Pharmocological therapy: reduces exacerbation frequency but doesn't improve survival/progression
Short acting B2-agonist eg. Salbutamol
Inhaled corticosteroids
Long acting B2-agonist
Long acting muscarinic antagonist

Long term oxygen therapy

8

ADRs of corticosteroids

Sore throat
Cough
Increased risk of pneumonia
Thinning of skin, bruises easily

9

Complications of COPD

Recurrent pneumonia
Pneumothorax
Respiratory failure
Cor pulmonale

10

COPD differential diagnosis

Asthma
Bronchiectasis
Alpha-1-antitrypsin deficiency
Heart failure