1
Q
Pathological changes
A
Chronic inflammation
Structural change
2
Q
Physiological abnormalities
A
Mucus hyper secretion Ciliary dysfunction Airflow limitation with hyperinflation Impaired gas exchange Pulmonary hypertension
3
Q
Risk factors
A
Smoking Indoor air pollution Occupational toxins Outdoor air pollution Genetic factors (alpha 1anti trypsin deficiency) Infections Socio-economic factors Asthma and airway hyperactivity
4
Q
history
A
Chronic progressive dyspnoea Chronic cough Regular sputum production wheezing and chest tightness Fatigue, weight loss?
5
Q
Examination findings
A
Hyperinflated chest Wheeze/quiet breath sounds Purse lip breathing Use of accessory muscles Peripheral oedema Cyanosis Raised JVP Cachexia
6
Q
Investigations for suspected COPD / differentials
A
CXR
FBC
BMI
Spirometry
Additional: peak flow, alpha 1 anti trypsin, pulse oximetry, CT thorax, ECG, echo, blood gas, sputum culture
7
Q
Treatment
A
saba or sama
Long acting muscarinic agonist. IF ineffective LABA/LAMA
-ICS if frequent exacerbations
-Smoking cessations
