What is Chronic Obstructive Pulmonary Disease (COPD)?
A grouping of lung diseases that damage the small or large airways permanently
increasing lung
... [Show More] compliance (Varying degrees of symptoms and exacerbations
between patients. Main forms are chronic bronchitis and emphysema)
Does smoking cause COPD?
No, but because of the way it interacts with the lungs it significantly increases the
chances that it will be developed.
What are 6 diseases that are frequently associated with a COPD diagnosis?
Osteoporosis, cardiovascular disease, skeletal muscle dystrophy, lung cancer,
depression, and anxiety
What are the 3 ways that emphysema changes the lungs? (Airways and lung
parenchyma)
Oxidative stress, airway remodeling, and enzyme-enzyme inhibitor imbalance
What are the 2 ways that chronic bronchitis changes the lungs? (Airway and lung
parenchyma)
Airway remodeling and hypersecretion of mucous
How does emphysema cause oxidative stress?
Cigarette smoke and particulates destroy the cells of the lungs. This signals an
inflammatory response where white blood cells release enzymes to break the
particles down causing further cell damage in the process. All of this cell damage
releases free radicals (highly reactive oxygen compounds that indiscriminately
destroy cells) further enhancing the cell damage.
How does emphysema cause airway remodeling?
Constant damage to the tissues causes smooth muscle generation (tougher cells to
protect against further damage) where it doesn't belong. This leads to fibrotic
changes to the airways, decreasing the airway lumen. (Increasing resistance)
How does emphysema cause enzyme-enzyme inhibitor imbalance?Methionine sulfate is produced in response to cigarette smoke which reduces the
activity of alpha 1 antitrypsin (enzyme for enzymes) allowing for increasing
number of proteases (enzymes for proteins) that damage cells
How does chronic bronchitis cause airway remodeling?
Constant inflammation causes enlargement of mucous glands and a thickening of
the airway walls.
How does chronic bronchitis cause hypersecretion of mucous?
Constant inflammation and damage leads to an increase in secretion and viscosity
of mucus. The products of inflammation and smoke particles impair ciliary
function, resulting in decreased mucous clearance
What are 4 common symptoms of COPD?
Persistent productive cough, increased production of mucous, PROGRESSIVE
dyspnea, and muscle fatigue
Are the lung changes caused by COPD permanent?
Yes
What is a basic way to describe emphysema?
The destruction of alveolar surface area leading to floppy (low elasticity) alveoli.
(Increased compliance and poor diffusion in late stages = air trapping)
What is panlobular emphysema?
Destruction of the distal (end/tip) of alveoli caused by alpha 1 antitrypsin
deficiency. (Aka lack of enzymes that stop inflammation from damaging healthy
cells)
What is centrilobular emphysema?
Destruction of the proximal alveoli (close to the bronchi) caused by smoking or
inhaling large particles.
What is a basic way to describe chronic bronchitis?
The presence of cough and sputum production for at least 3 months in each of two
consecutive yearsWhat is the most important thing that patients can do to help delay the progression
of COPD?
Tobacco cessation
What are 6 risk factors that increase the chances of developing COPD?
Alpha 1 antitrypsin deficiency, age/gender, conditions that affect normal lung
growth, exposure to particles, reoccurent infections in the lung, and socioeconomic
status.
What is a ventilator setting that you can change to improve ventilations of a COPD
patient?
Increasing PEEP
What is dynamic compression?
It is when the walls of the airways go flat because of normal increasing pleural
pressure (the increased compliance caused by COPD leads to dynamic
compression happening earlier than normal, leading to air trapping)
What pulmonary function result is used to formally diagnose COPD from other
conditions with similar symptoms?
A post-bronchodilator FEV1/FVC ratio less than 0.70 (An asthma patient would
always have a post-bronchodilator ratio above 0.7 FEV1/FVC: Forced expiratory
volume in one second/Forced vital capacity.)
What would classify a patient with a post bronchodilator FEV1/FVC < 0.70
(COPD diagnosis) as GOLD 1?
A FEV1≥80% predicted. Mild airflow limitation
What would classify a patient with a post bronchodilator FEV1/FVC < 0.70
(COPD diagnosis) as GOLD 2?
A predicted 50%≤FEV1<80%. Moderate airflow limitation
What would classify a patient with a post bronchodilator FEV1/FVC < 0.70
(COPD diagnosis) as GOLD 3?
A predicted 30% ≤ FEV1 < 50%. Severe airflow limitation [Show Less]