COPD Session 2 PDF

Chronic Obstructive Pulmonary Disease (COPD) Principles of medicine part 2/Practice (session 2) Anesthesia department /Stage 3 Chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulti...

Chronic Obstructive Pulmonary Disease (COPD) Principles of medicine part 2/Practice (session 2) Anesthesia department /Stage 3 Chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties, because of restricted air flow. It includes: emphysema – damage to the air sacs in the lungs chronic bronchitis – long-term inflammation of the airways  COPD is a common condition that mainly affects middle-aged or older adults who smoke. Many people do not realise they have it. The breathing problems tend to get gradually worse over time and can limit normal activities, although treatment can help keep the condition under control. Most people with COPD do not have any noticeable symptoms until they reach their late 40s or 50s. Sometimes there may be periods when the symptoms get suddenly worse – known as a flare-up or exacerbation. It's common to have a few flare-ups a year, particularly during the winter. Symptoms: Less common symptoms of COPD include: weight loss tiredness swollen ankles from a build-up of fluid (oedema) chest pain and coughing up blood – although these are usually signs of another condition, such as a chest infection or possibly lung cancer These additional symptoms only tend to happen when COPD reaches an advanced stage. Cyanosis & Clubbing of finger Diagnosis: ask about the symptoms examine the chest and listen to breathing using a stethoscope ask whether patient smoke or used to smoke calculate the body mass index (BMI) using weight and height ask if have a family history of lung problems a breathing test called spirometry, plus other related tests of the lungs and airways.  Spirometry: A test called spirometry can help show how well lungs are working. You ask patient to breathe into a machine called a spirometer after inhaling a medicine called a bronchodilator, which helps widen airways. The spirometer takes 2 measurements: the volume of air can breathe out in a second, and the total amount of air breathe out. You may be ask to breathe out a few times to get a consistent reading. The readings are compared with normal results for the age, which can show if airways are obstructed. Spirometry results: Chest x ray: A chest X-ray can be used to look for problems in the lungs that can cause similar symptoms to COPD. Problems that can be shown by an X-ray include chest infections and lung cancer, although these do not always show. COPD x-ray Blood test: A blood test can show other conditions that can cause similar symptoms to COPD, such as a low iron level (anaemia) and a high concentration of red blood cells in the blood (polycythaemia). Sometimes a blood test may also be done to see if have alpha-1- antitrypsin deficiency. This is a rare genetic problem that increases risk of COPD. Further tests: Sometimes more tests may be needed to confirm the diagnosis or determine the severity of COPD. These tests may include: an electrocardiogram (ECG) an echocardiogram – an ultrasound scan of the heart a peak flow test – a breathing test that measures how fast can blow air out of lungs, which can help rule out asthma a blood oxygen test. a CT scan – a detailed scan that can help identify any problems in lungs a phlegm sample – a sample of the phlegm (sputum) may be tested to check for signs of a chest infection ECG changes: Treatment: There's currently no cure for chronic obstructive pulmonary disease (COPD), but treatment can help slow the progression of the condition and control the symptoms. Treatments include: stopping smoking – this is the most important thing to do inhalers and tablets – to help make breathing easier pulmonary rehabilitation – a specialized programme of exercise and education surgery or a lung transplant – although this is only an option for a very small number of people Emphysema Is a condition that involves damage to the walls of the air sacs (alveoli) of the lung.  When emphysema develops, the alveoli and lung tissue are destroyed. With this damage, the alveoli cannot support the bronchial tubes. The tubes collapse and cause an “obstruction” (a blockage), which traps air inside the lungs. Too much air trapped in the lungs can give some patients a barrel-chested appearance. Also, because there are fewer alveoli, less oxygen will be able to move into the bloodstream.  Symptoms: Shortness of breath, especially during light exercise or climbing steps Ongoing feeling of not being able to get enough air Long-term cough or “smoker’s cough” Wheezing Long-term mucus production Ongoing fatigue How is emphysema diagnosed? The diagnosis of emphysema cannot be made solely on symptoms. Several tests are used to make the diagnosis. X-rays: Pulse oximetry: Spirometry and pulmonary function tests (PFT): Arterial blood gas: This test measures the amount of oxygen and carbon dioxide in blood from an artery. It is a test often used as emphysema worsens. It is especially helpful in determining if a patient needs extra oxygen. Electrocardiogram (ECG): ECGs check heart function and are used to rule out heart disease as a cause of shortness of breath. X ray: X ray – Emphysema CT scan: Chronic bronchitis: That’s when the air tubes in the lungs called bronchi get irritated and inflamed, and have coughs for at least 3 months a year for 2 years in a row. It’s a long-term illness that keeps coming back or never fully goes away. Symptoms fills the airways with thick mucus. The small hairs that normally move phlegm out of lungs are damaged. That makes cough. As the disease goes on, it’s harder for patient to breathe. Other signs of chronic bronchitis may include: Cough, often with mucus Wheezing Tight chest Shortness of breath Feeling tired The symptoms may be worst in the winter, when humidity and temperatures drop. Diagnosi s: Pulmonary function tests: Chest X-ray:. Computed tomography: CT scan. Treatment Airway openers (bronchodilators): Anti-inflammatory drugs: Steroids Oxygen therapy: This is for serious cases. Specialized rehab program: Bronchial asthma: Is a disease that affects the lungs. It’s a chronic (ongoing) condition, meaning it doesn’t go away and needs ongoing medical management. Types of asthma: Exercise-induced asthma: This type is activated by exercise and is also called exercise-induced bronchospasm. Occupational asthma: This type of asthma happens primarily to people who work around irritating substances. Asthma-COPD overlap syndrome (ACOS): This type happens when have both asthma and chronic obstructive pulmonary disease (COPD). Both diseases make it difficult to breathe. Signs and symptoms: Chest tightness, pain or pressure. Coughing (especially at night). Shortness of breath. Wheezing. Diagnosis: Review of medical history. Spirometry. Chest x ray. Treatmen t: Bronchodilator: This relax the muscles around the airways. Anti-inflammatory medicines: These medicines reduce swelling and mucus production in the airways. Biologic therapy: this may be used in sever cases of asthma.