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1

What is COPD?

Chronic bronchitis or emphysema

2

What is chronic bronchitis?

Airway obstruction (narrow airways)

3

What is emphysema?

Hyperinflation (damaged alveoli making gas exchange more difficult)

4

What caused the airway to narrow?

Mucus builds up

Airway muscles tighten

Airway lining swells up (inflamation)

5

What are symptoms of COPD?

Breathlessness

Cough

Recurrent chest infection

6

What is the most common reason why people develop COPD?

Tobacco smoke

7

Why does tobacco smoke cause COPD?

1) Nicotine and oxygen free radicals in tobacco acts on neutrophils causing them to degranulate and inactivates anti-proteases

2) Releases neutrophil elastase inactivates anti proteases and causes tissue damage

8

What does tobacco smoke do to neutrophils?

Causes them to degranulate and release elastase

9

What does tobacco smoke do to anti-proteases?

Inactivates them

10

What does COPD cause not within the respiratory system?

Loss of muscle mass

Weight loss

Cardiac disease

Depression

Anxiety

11

How do you diagnose COPD?

Relevent history (symptoms)

Look for clinical signs

Confirmation of diagnosis and assessment of severity

Other relevent tests

12

When would you suspect COPD?

35 years or more

Current or former smoker

Chronic cough

Exertional breathlessness

Sputum production

Frequent winter bronchitis

Wheeze

Chest tightness

13

What is the difference in age between COPD and asthma?

COPD is generally older than 35

Asthma is any age

14

What is the difference between the cough due to COPD and asthma?

COPD cough is persistent and productive

Asthma cough is intermitten and non-productive

15

What is the difference between smoking in COPD and asthma?

COPD smoking is almost invariable

Asthma smoking is possible

16

What is the difference in breathlessness between COPD and asthma?

COPD is progressive and persistant

Asthma is intermittent and variable

17

What is the difference in nocturnal symptoms in COPD and asthma?

COPD is uncommon unless in severe distress

Asthma is common

18

What is the difference in family history in COPD and asthma?

COPD is uncommon unless family members also smoke

Asthma is common

19

What is the difference in allergies between COPD and asthma?

COPD is possible

Asthma is common

20

What is typically seen in a COPD examination?

May be normal in early stages

Reduced chest expansion

Prolonged expiration/wheeze

Hyperinflated chest

Respiratory failure

 

21

What is the chest expansion like in COPD?

Reduced

22

What is the inflation of the chest like in COPD?

Hyperinflated chest

23

What is the expiration like in COPD?

Prolonged/wheeze

24

What are signs of respiratory failure?

Tachypneoa

Cyanosis

Use of accessory muscles

Pursed lip breathing

Peripheral oedema

25

What is tachypneoa?

Abnormally rapid breathing

26

What is the process of the COPD diagnosis?

Clinical history (cough, breathlessness, chest infections, winter bronchitsis)

Examination (may be normal, tachypneoa, wheeze, hyperinflated chest)

Spirometry (confirms diagnosis and assesses severity)

27

What is used to confirm the diagnosis of COPD and assess the severity?

Spirometry

28

When is spirometry obstructive?

When FEV1/FVC is less than 70%

29

What are the different levels of COPD severity?

Mild (FEV1​ >80%)

Moderate (FEV1​ 50-79%)

Severe (FEV1​ 30-49%)

Very severe (FEV1​ <30%)

 

All values are relative to the predicted FEV1 (70% of FVC)

30

When is COPD mild?

FEV1​ > 80%