Chronic Obstructive Pulmonary Disease
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Chronic Obstructive Pulmonary Disease - Marcador
Chronic Obstructive Pulmonary Disease - Detalles
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| 🇬🇧 | 🇬🇧 |
| What is COPD | The airflow obstruction is usually progressive, not fully reversible, and does not change markedly over several months Not fully reversible is an important diagnostic marker The disease is predominantly caused by smoking |
| What is emphysema | A pathological process in which there is destruction of the terminal bronchioles and distal airspaces Leads to loss of alveolar surface area → Reduced ventilation |
| What can emphysema lead to | Destruction of tissues removes ‘scaffolding’ support of small airways, which tend to collapse Leads to airflow obstruction Lung recoil reduced so lungs have higher resting expiratory level --> Hyperinflation Bullae can also burst leading to pneumothorax |
| What are the 2 types of emphysema | Centrilobular --> occurs primarily in the upper lobes due to loss of bronchioles Panlobular --> Involves all lung fields |
| What is chronic bronchitis | Chronic mucus hypersecretion --> frequent infections and a persistent cough This leads to increase amount of inflammation in the airways which leads to remodelling and narrowing of the airways |
| What are some causes of COPD | Vast majority in HICs due to smoking Alpha 1 antitrypsin deficiency --> young patients presenting with COPD Occupational exposure eg coal dust Pollution --> including indoor smoke pollution |
| What are some common symptoms of COPD | Cough and sputum production Followed by progressive breathlessness → dyspnoea Increasingly frequent exacerbations Breathlessness |
| What are some signs of COPD | Pursed lip breathing --> to increase pressure to keep the airways open Usage of accessory muscles Tachypnoea Wheezing/quiet breath sounds Hyperinflation |
| As the disease progresses what can happen | Cyanosis Carbon dioxide retention Right heart failure |
| What are some differences between Asthma and COPD | Smoker or ex smoker → Almost every time in COPD but possibly in Asthma Symptoms under age of 65 → Rare in COPD and often in asthma Chronic cough → Common in COPD but not Asthma Nighttime waking with breathlessness → Common in Asthma not in COPD Significant day-day variability of symptoms → Common in Asthma not in COPD |
| What are some investigations you can run | Spirometery Chest x-ray not diagnostic but can help High resolution CT scan can help to assess destruction in emphysema Arterial blood gases to assess respiratory failure Alpha-1 anti trypsin assay for younger patients |
| What is cor pulmonale | Cor pulmonale is a condition that causes the right side of the heart to fail. Long-term high blood pressure in the arteries of the lung and right ventricle of the heart can lead to cor pulmonale |
| What are some management plans | Smoking cessation support Pulmonary rehabilitation Bronchodilators Diet Steroids Influenza vaccination Long term oxygen therapy in advanced disease Drugs such as : Beta-2 agonists , Antimuscarinics , Corticosteroids |
| What are some adverse effects of beta-2 agonists | Tachycardia Tremor Anxiety Palpitations Hypokalaemia |
| What are some adverse effects of Anti-muscarinics | Acute glaucoma Urinary difficulty → urinary retention Atrial fibrillation Tachycardia |
| What are some adverse effects of corticosteroids | Thin skin Bruising Diabetes / Osteoporosis Cataracts Increased weight |
| What are Blue bloaters and pink puffers mean? | The” blue bloaters” represent those who have chronic bronchitis and the “pink puffers” represent patients with emphysema |