COPD

Question 1

patients with COPD on standard treatments that still have exacerbations should be offered..

Answer 1

prophylactic antibiotics e.g. azithromycin

once a LFT and ECG done and other conditions ruled out

Question 2

what is theophylline

Answer 2

treatment for lung diseases - phosphodiesterase inhibitor (relaxes smooth muscle)

Question 3

what to do if theophylline patient is given macrolides or fluoroquinolones (antibiotics)

Answer 3

reduce dose

Question 4

what is the first treatment approach for COPD

Answer 4

short and long acting bronchodialtors

Question 5

second line treatment if inhaled therapies are not effective or unable to take

Answer 5

oral theophylline

Question 6

investiagtions for COPD

Answer 6

post bronchodialtor spirometry (irrevrsible FEV1/FVC <70%)

CXR - hyperinflation, bullae, diaphragm flattening

FBC - secondary polycythaemia (haemoglobin) caused by chronic hypoxia

Question 7

What genetic change predisposes someone to COPD?

Answer 7

alpha-1 antitrypsin deficiency

Question 8

stage 2 COPD FEV1 of predicted =

Answer 8

50-79%

Question 9

stage 3 COPD FEV1 of predicted =

Answer 9

30-49%

Question 10

stage 4 COPD FEV1 of predicted =

Answer 10

<30

Question 11

stage 1 COPD FEV1 of predicted =

Answer 11

at least 80%

Question 12

What is the management of Cor Pulmonale in COPD patients?

Answer 12

loop diuretic

Question 13

What is the out of hospital management of COPD exacerbations?

Answer 13

bronchodialtors
prednisolone - 5 days
ABX (Doxycyline, amoxicillin or clarithromycin) - if necessary

Question 14

what to offer COPD patients with chronic productive cough

Answer 14

mucolytics e.g. carbocisteine

Question 15

1st and 2nd line treatment COPD - no asthma

Answer 15

1= LABA, LAMA
2= triple therapy (LABA, LAMA, ICS)

Question 16

1st and 2nd line treatment COPD - with asthma

Answer 16

1= LABA, ICS
2= triple therapy (LAMA, LABA, ICS)

Question 17

features of COPD

Answer 17

chronic productive cough
extertional dysponea
wheeze
right-sided heart failure (raised JVP or peripheral oedema)
reccurent chest infections