Internal Medicine COPD

Anatomical Changes and Physiological changes of Emphysema

Anatomical Changes

• Destruction of elastic fibers

• reduced lung recoil

• expansion of the remaining lung tissue

• enlargement of wall airspaces

Physiological

• Air trapping

• elastic recoil

• airway resistance

Anatomical changes and Physiological changes for Chronic Bronchitis

Anatomical Changes

• Inflammation of the Bronchi

• Secreting glands

• Thickened bronchial walls

• airway fibrosis

Physiological Changes

• Airway resistance

• Airway Obstruction/Airway plugging

• Pulmonary Hypertension

What is the slang word for Emphysema?

Pink Puffers

What is the slang word for Chronic Bronchitis?

Blue Bloaters

Which diagnostic test is BEST for diagnosing COPD as the GOLD standard?

Spirometry (post- bronchodilator spirometry)

What are some of the anatomical changes found with COPD?

airway narrowing, loss of elastic recoil, and destruction of alveolar walls.

What are the different categories of emphysema defined or described by anatomical changes?

Cigarette smoking, Alpha 1 antitrypsin deficiencies, infections inhaled irritants.

What are some of the changes seen on CXRay for emphysema?

Translucent, flattened diaphragm, and enlarged heart

What is the GOLD definition of chronic bronchitis.

Has a chronic productive cough for three months for two consecutive years. Chronic cough has to be excluded.

What are the common causes of COPD and which is MOST common and what are common treatment approaches once admitted to the hospital?

Cigarette smoking, AAT deficiency, outdoor pollution, long standing asthma, biomass and occupational exposure.

• AAT with purified preparation of AAT from human blood donors

• lung transplantation

• lung volume reduction surgery

• continuous O₂

• Long-term oxygen therapy

• annual influenza and pneumococcal vaccination

• smoking cessation.

What is the PFT range for mild?

80%

What is the PFT range for for Moderate?

50%-79%

What is the PVT range for Severe?

30%-49%

What is the PFT range for Very Severe?

less than 30%

What is the differences found between chronic bronchitis and emphysema?

-Emphysema structural changes

• enlargement and deterioration of the air spaces

• destruction of pulmonary capillaries

• weakening of the airways primarily the respiratory bronchioles

-Chronic Bronchitis structural changes

• chronic inflammation and swelling of the peripheral airways

• excessive mucous production and accumulation

• bronchial airway obstruction, and hyper-inflated alveoli