COPD Lecture
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Questions and Answers

What is a common symptom of COPD that patients often experience?

  • Haemoptysis
  • Wheezing
  • Cough and sputum production (correct)
  • Pleuritic chest pain

    • What is a complication of COPD that can lead to respiratory failure?

  • Muscle wasting
  • Osteoporosis
  • Impaired nutrition
  • Pulmonary vascular remodeling (correct)

    • At what age should COPD be suspected in a patient with chronic cough or breathlessness?

  • 30 years
  • 60 years
  • 40 years (correct)
  • 50 years

    • What is a physical examination finding in severe COPD?

    <p>Cyanosis</p> Signup and view all the answers

    What is a feature of COPD that worsens over time?

    <p>Dyspnea</p> Signup and view all the answers

    What is a systemic feature of COPD?

    <p>Muscle wasting</p> Signup and view all the answers

    What is a reason for suspecting another condition rather than COPD as the cause of haemoptysis?

    <p>Haemoptysis requires thorough investigations to exclude other conditions</p> Signup and view all the answers

    What is a breathing pattern observed in patients with severe COPD?

    <p>Pursed-lip breathing</p> Signup and view all the answers

    In COPD patients, what is the characteristic feature of the chest?

    <p>Barrel chest</p> Signup and view all the answers

    What is the typical finding on cardiac examination in COPD patients?

    <p>Loud heart sounds in the epigastrium</p> Signup and view all the answers

    What is the characteristic lung finding in COPD patients?

    <p>Hyper-resonance</p> Signup and view all the answers

    What is the significance of finger clubbing in COPD patients?

    <p>It suggests associated lung cancer, bronchiectasis or fibrosis</p> Signup and view all the answers

    What is the significance of oedema in COPD patients?

    <p>It is a sign of right heart failure</p> Signup and view all the answers

    What is the typical spirometry finding in COPD patients?

    <p>FEV1/FVC ratio &lt; 80% of predicted</p> Signup and view all the answers

    What is the typical medication used in COPD patients?

    <p>All of the above</p> Signup and view all the answers

    What is the typical dose of oral prednisolone used in COPD patients?

    <p>40 mg daily for 5 days</p> Signup and view all the answers

    What is the definition of COPD?

    <p>A preventable and treatable disease characterized by persistent respiratory symptoms and airflow limitation</p> Signup and view all the answers

    What is the main risk factor for COPD?

    <p>Cigarette smoking</p> Signup and view all the answers

    What is the prevalence of COPD worldwide?

    <p>Around 80 million people</p> Signup and view all the answers

    At what age is COPD more prevalent?

    <p>After 40 years of age</p> Signup and view all the answers

    What is the expected ranking of COPD as a cause of death in the coming decade?

    <p>3rd leading cause of death</p> Signup and view all the answers

    What is emphysema?

    <p>An anatomically defined condition characterized by abnormal permanent enlargement of the airspaces</p> Signup and view all the answers

    What is the minimum pack year required to develop COPD?

    <p>10 pack year</p> Signup and view all the answers

    What is chronic bronchitis?

    <p>A clinically defined condition characterized by cough and sputum on most days for at least 3 months in each of 2 successive years</p> Signup and view all the answers

    What is a common mode of cooking in some countries that leads to high levels of indoor pollution?

    <p>Biomass solid fuel fires</p> Signup and view all the answers

    What is associated with early onset COPD with predominant emphysema?

    <p>Alpha-1-antitrypsin deficiency</p> Signup and view all the answers

    What is the main component of the inflammatory cell infiltration in chronic bronchitis?

    <p>Neutrophils</p> Signup and view all the answers

    What is the result of the balance between the elastic recoil of the lung and the resistance of the airways?

    <p>Airflow during expiration</p> Signup and view all the answers

    What is the main pathology in COPD?

    <p>Airway limitation</p> Signup and view all the answers

    What is the result of the progressive destruction of the alveolar cells and matrix in emphysema?

    <p>Enlargement of the distal airspaces</p> Signup and view all the answers

    What may form in some patients with emphysema?

    <p>Bullae</p> Signup and view all the answers

    What is a contributing factor to the development of airflow obstruction in COPD?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    Definition and Epidemiology

    • COPD is a preventable and treatable disease characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities.
    • The prevalence of COPD is directly proportional to the prevalence of smoking in the community.
    • Around 80 million people worldwide suffer from moderate to severe COPD.
    • COPD is more common in men, but the prevalence among women is increasing.
    • The disease is more prevalent after 40 years of age.

    Aetiology

    • Cigarette smoking is the major risk factor for COPD (accounts for 95% of cases) and relates to both the amount and duration of smoking.
    • Other exposures that contribute to COPD include biomass solid fuel fires, occupational exposure to coal, silica, and cadmium, and low birth weight and impaired lung growth in childhood.
    • Genetic factors, such as alpha-1-antitrypsin deficiency, can also contribute to early onset COPD.

    Pathology

    • COPD has both pulmonary and systemic components.
    • Chronic bronchitis is characterized by excess goblet cells and enlarged mucus-secreting glands with inflammatory cell infiltration, resulting in increased sputum production.
    • Emphysema is characterized by chronic exposure to cigarette smoke, leading to inflammatory cell recruitment, protease release, and alveolar cell death.
    • Airway limitation (obstruction) results from both small airway obstruction and emphysema.

    Clinical Features

    • COPD should be suspected in patients over 40 years old with chronic cough or breathlessness.
    • Symptoms include chronic cough, sputum production, and exertional dyspnoea.
    • As the disease advances, dyspnoea worsens, and patients become breathless on doing simple activities of daily living and even at rest.
    • Physical examination may reveal breathlessness, prolonged expiration, pursed-lip breathing, and use of accessory muscles of inspiration.

    Investigations

    • The diagnosis of COPD requires objective demonstration of persistent airflow obstruction by spirometry.
    • FEV1/FVC ratio is used to classify disease severity: moderate (50% - 80%), severe (30% - 50%), and very severe (<30%).

    Management

    • Bronchodilators, such as SABA (salbutamol) combined with ipratropium bromide, are used to treat COPD.
    • Corticosteroids, such as oral prednisolone, reduce symptoms and improve lung function.
    • Oxygen therapy is used to manage acute exacerbations, but high concentration of oxygen may cause respiratory depression.

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    Description

    This quiz covers the definition, pathophysiology, diagnosis, and management of Chronic Obstructive Pulmonary Disease (COPD).

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