Chronische obstruktive Bronchitis (COPD)

Chronische obstruktive Bronchitis (COPD)

• Definition: A patient has chronic bronchitis if they have a productive cough for at least three months in two consecutive years. If bronchial hyperreactivity is also present, it is classified as chronic obstructive bronchitis.

• Causes: Inflammation of the airways, smoking (including passive smoking), environmental factors (e.g., particulate matter), and genetic factors.

• Pathophysiology: Chronic inflammation leads to permanent lung damage. The bronchial lining changes, resulting in excessive mucus production that can't be properly transported. This obstruction leads to hyperinflation of the peripheral lung sections and decreased lung reserve.

• Symptoms: Chronic productive cough, shortness of breath (dyspnea), initially triggered by exertion, then present even at rest. Patients often assume postures to ease breathing, wheezing and whistling sounds, bluish discoloration of the skin (cyanosis), fatigue, and reduced general health.

Diagnosis

• Diagnostic methods: Medical History, physical examination (chest appearance), X-rays of the chest (specifically looking for flattened diaphragm), CT scans (especially when the lungs appear translucent), pulmonary function tests (assessing obstruction of the airways, specifically the FEV1 - Forced Expiratory Volume in one second), blood tests (to analyse blood gases), and examination of sputum (to check for bacteria).

• Classification (Gold Standard): COPD is staged based on FEV1 values compared to predicted values. Stages range from 1 to 4 (with 1 being least severe and 4 being the most severe). Stage 1: FEV1 > 80% predicted; Stage 2: FEV1 50-80% predicted; Stage 3: FEV1 30-50% predicted; Stage 4: FEV1 < 30% predicted or FEV1 < 50% predicted + chronic respiratory insufficiency.

Complications

• Acute exacerbation: Often triggered by viral or bacterial infections. Increased sputum production, which becomes thick and yellow/green, hyperventilation, fever, making it difficult for the patient to expel sputum and worsening the condition.
• Other complications: Respiratory failure, cor pulmonale (right-sided heart failure due to lung disease), nutritional deficiencies, and infections.

Treatment

• Management: Smoking cessation is crucial. Bronchodilators (inhaled medications), corticosteroids (inhaled or oral), mucolytics (to thin mucus), oxygen therapy, and pulmonary rehabilitation (exercise and breathing programs).

Dieses Quiz befasst sich mit der chronischen obstruktiven Bronchitis (COPD). Es behandelt die Definition, Ursachen, Pathophysiologie und Symptome der Erkrankung. Testen Sie Ihr Wissen über die wichtigsten Aspekte von COPD und deren Auswirkungen auf die Lunge.