COPD

Question 1

What is COPD?

Answer 1

A chronic lung disease including emphysema and chronic bronchitis, causing irreversible airflow obstruction

Question 2

What does COPD stand for?

Answer 2

Chronic Obstructive Pulmonary Disease

Question 3

Why is COPD a major global health issue?

Answer 3

It is the 4th leading cause of death worldwide, responsible for ~3.5 million deaths in 2021

Question 4

What causes COPD?

Answer 4

Long‑term exposure to toxic gases/particles (especially cigarette smoke) leading to chronic inflammation and airway damage

Question 5

What characterises COPD pathophysiology?

Answer 5

• Poorly reversible airway obstruction
• Abnormal inflammatory response to toxins
• Structural airway changes
• Progressive airflow limitation

Question 6

What is emphysema?

Answer 6

Destruction of alveolar air sacs → loss of elastic recoil → reduced gas exchange

Question 7

What is chronic bronchitis?

Answer 7

Chronic inflammation and mucus hypersecretion causing persistent productive cough

Question 8

What is bronchiolitis in COPD?

Answer 8

Inflammation and fibrosis of small airways due to disrupted repair mechanisms

Question 9

What causes airflow limitation in COPD?

Answer 9

• Airway narrowing
• Mucus hypersecretion
• Oedema
• Bronchospasm

Question 10

What causes loss of elastic recoil?

Answer 10

Destruction of alveolar walls (emphysema)

Question 11

What is air trapping?

Answer 11

Gas remains in alveoli after exhalation due to airway narrowing and mucus plugging

Question 12

What inflammatory cells drive COPD?

Answer 12

Neutrophils and macrophages releasing destructive mediators

Question 13

What is a COPD exacerbation?

Answer 13

Acute worsening of airflow limitation due to increased airway inflammation or obstruction

Question 14

What is alpha‑1 antitrypsin deficiency?

Answer 14

A rare genetic disorder causing early‑onset emphysema and liver disease

Question 15

What are early symptoms of alpha‑1 antitrypsin deficiency?

Answer 15

• Breathlessness
• Wheezing
• Reduced exercise tolerance
• Recurrent infections
• Barrel chest
• Early emphysema (worse with smoking)

Question 16

What are common COPD symptoms?

Answer 16

• Breathlessness (dyspnoea)
• Persistent chesty cough with phlegm
• Frequent chest infections
• Wheezing

Question 17

What are less common symptoms?

Answer 17

• Weight loss
• Fatigue
• Oedema
• Chest pain
• Haemoptysis

Question 18

What is a flare‑up?

Answer 18

Sudden worsening of symptoms, often triggered by infection

Question 19

What conditions are more common in COPD patients?

Answer 19

• Pneumonia
• Lung cancer
• Heart disease
• Osteoporosis
• Muscle weakness
• Depression/anxiety

Question 20

What is the main cause of COPD in high‑income countries?

Answer 20

Tobacco smoking (~70% of cases)

Question 21

What is the main cause of COPD in low‑ and middle‑income countries (LMICs)?

Answer 21

Indoor air pollution from biomass fuels (wood, dung, crop residue) and coal

Question 22

What other risk factors contribute to COPD?

Answer 22

• Occupational dusts/fumes
• Second‑hand smoke
• Prematurity
• Severe childhood respiratory infections
• Poor early lung growth

Question 23

When should COPD be suspected?

Answer 23

In adults >35 with risk factors and symptoms such as dyspnoea, chronic cough, sputum, wheeze, or recurrent infections

Question 24

What is dyspnoea?

Answer 24

Persistent breathlessness, worse on exertion

Question 25

What test confirms COPD?

Answer 25

Spirometry

Question 26

What spirometry result confirms COPD?

Answer 26

Post‑bronchodilator FEV₁/FVC < 0.7. * FEV₁: Forced Expiratory Volume in 1 second * FVC: Forced Vital Capacity

Question 27

What does GOLD stand for?

Answer 27

Global Inititive for Chronic Obstructive Lung Disease

Question 28

What are the GOLD spirometry stages?

Answer 28

* Stage I (Mild): FEV₁ ≥ 80% predicted * Stage II (Moderate): 50–79% * Stage III (Severe): 30–49% * Stage IV (Very Severe): <30%

Question 29

What lifestyle changes are essential in COPD?

Answer 29

* Smoking cessation * Avoiding second‑hand smoke * Avoiding indoor cooking smoke * Exercise and active lifestyle * Vaccinations (flu, pneumonia, COVID‑19)

Question 30

What is the ABE scheme in COPD?

Answer 30

A classification based on: * A: Airflow obstruction * B: Blood eosinophils * E: Exacerbations/hospitalisations Also uses mMRC (modified Medical Research Council dyspnoea scale) and CAT™ (COPD Assessment Test).

Question 31

What is the role of rescue medication?

Answer 31

Short‑acting bronchodilators for immediate symptom relief

Question 32

Why is LABA+ICS not recommended in COPD?

Answer 32

ICS alone with LABA is less effective; triple therapy (LABA+LAMA+ICS) is superior when ICS is indicated

Question 33

What treatments are used during exacerbations?

Answer 33

* Steroids * Antibiotics * Nebulised bronchodilators * Oxygen (if hypoxic)

Question 34

What is pulmonary rehabilitation?

Answer 34

A structured exercise and education programme to iprove breathing and functional capacity

Question 35

When is surgery considered?

Answer 35

In severe COPD (e.g., lung volume reduction surgery)

Question 36

What is the hallmark of COPD?

Answer 36

Irreversible airflow obstruction

Question 37

What is the most important intervention to slow COPD progression?

Answer 37

Smoking cessation

Question 38

What spirometry ratio confirms COPD?

Answer 38

FEV₁/FVC < 0.7 post‑bronchodilator