Summary
Summary Essential Notes: Respiratory Medicine: COPD
- Module
- Medicine (MBBS)
- Institution
- St Georges (University Of London)
Personal revision notes compiled from a combination of lecture notes and textbooks. Notes created between .
[Show more]
Seller
Follow
Content preview
Chronic Obstructive Pulmonary Disease Mx(COPD) Stable COPD
General Mx
Smoking cessation
Definition chronic obstructive pulmonary disease that is characterised
by its irreversibility Annual influenzae vaccination
Associated w/ smoking One-off pneumococcal vaccination
1. Chronic bronchitis (chronic infiltration of respiratory submucosal 1. Bronchodilator = SABA + SAMA 1st line
by inflammatory cells mucous gland hyperplasia + SM For pts who remain breathless/have exacerbations
hypertrophy = ‘Blue bloaters’)
next step (determined by FEV1)
Cough w/ sputum production for at least 3 months in 2
consecutive years FEV1>50% LABA e.g. Salmeterol/ LAMA e.g.
2. Emphysema (Permanently dilated airways distal to terminal tiotropium
bronchioles w/ alveolar destruction + bullae formation FEV1<50% LABA + ICS/ LAMA
Defined histologically + associated w/ α1-antitrypsin deficiency 2. Theophylline (reduced dose w/
(protects against proteases) + increased elastase activity = ‘Pink
macrolide/fluoroquinolone)
puffers’)
Aetiology ‘GASES’ 3. Mucolytics e.g. Carbocisteine
Genetics α1-antitrypsin deficiency loss of protection
Air pollution Acute exacerbations
Smoking Common organisms: Haemophilus influenzae, strep.
Exposure through occupation e.g. coal mining, cadmium, cotton
pneumoniae, Moraxella catarrhalis
Second-hand smoke exposure
1. Increase frequency of bronchodilator/consider giving
Dx Pts > 35 years who are smokers/ex-smokers + have symptoms such via nebuliser
as exertional breathlessness, chronic cough/regular sputum production 2. Give prednisolone 30mg daily for 7-14 days
Ix Post-bronchodilator spirometry to demonstrate airway obstruction: 3. Do not give Abx unless sputum is purulent/ signs of
FEV1/FVC < 0.7
pneumonia
CXR Hyperinflation, bullae, flat hemi-diaphragm, exclude lung ca.
Bloods FBC- exclude secondary polycythaemia
ECG Cor pulmonale Long-term oxygen therapy (LTOT)
Assessment ABG on 2 occasions at least 3 weeks apart w/
Post bronchodilator stable COPD + optimal Mx
FEV1 (of predicted) Stage
FEV1/FVC Offer LTOT pO2 < 7.3kPa OR pO2 7.3-8kPa +
< 0.7 > 80% I – Mild
Secondary polycythaemia
< 0.7 50-79% II – Moderate
Nocturnal hypoxaemia
< 0.7 30-49% III – Severe
< 0.7 < 30% IV – Very severe
Peripheral oedema
Pulmonary HTN
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Noteorious. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £2.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79976 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy revision notes and other study material for 14 years now