1
Q
Difference between
- COPD
- Emphysema
- Chronic bronchitis
A
- COPD - a lung disease
- Progressive and irreversible lung disease characterised by persistent airflow limitation
gas trapping and an enhanced chronic inflammatory response.
- Emphysema - a description of lung changes
- Destruction of alveolar walls
- Narrowing of small airways
- Chronic bronchitis - a description of symptoms
- Chronic productive cough >3 months a year for >2 years
- Can occur before COPD develops
2
Q
Risk factors for developing COPD (4)
A
- Smoking
- Air pollutants (poorly vented cooking, heating fires)
- Occupational exposure (coal miners, gold miners, welders, silica)
- Family history (alpha 1-antitrypsin deficiency)
3
Q
Precipitants of COPD exacerbations (4)
A
- Infection
- Environmental irritants
- Cold weather
- PE
- Change to management
4
Q
Symptoms of COPD (2)
A
- Dyspnoea
- Chronic productive cough
5
Q
Signs of COPD on auscultation (2)
A
- Decreased air entry
- Wheeze
6
Q
GOLD grading of COPD severity on spirometry
A
7
Q
Signs of COPD on CXR (4)
A
- Overexpanded lungs
- Flattened diaphragm
- Increased retrosternal space
- Bullae
8
Q
ABCD assessment of COPD severity
A
9
Q
Lifestyle management of COPD (4)
A
- Smoking cessation
- Physical activity
- Flu vaccine, pneumococcal vaccine
- Pulmonary rehabilitation
10
Q
Pharmacological management of COPD (according to ABCD severity groups)
A
- SABA - salbutamol, terbutaline
- SAMA - ipratropium
- LABA - salmeterol, eformeterol
- LAMA - tiotrpium
- ICS - fluticasone, budesonide
- Oral corticosteroids - treat and prevent acute exacerbations, no mortality benefit when used alone
- Theophylline - consider at any stage, beware of harms
- Antibiotics (macrolide) - prevent exacerbations
11
Q
Complications of COPD (2)
A
- Right heart strain (cor pulmonale)
- Vigorous coughing → rib fractures, syncope
Respiratory
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Decks in class (14)
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