western path week 11 - COPD+

What is COPD?

Chronic inflammatory lung disease that causes tissue destruction and irreversible air flow limitation, including chronic bronchitis and emphysema. Clinical syndrome. Progressive.

What is the most common risk factor for COPD?

Smoking, which increases neutrophils and elastase enzymes that lead to rapid breakdown of alveolar structures.

What are the causes/contributing factors to COPD?

Smoking, airway infection, air pollution, dust and chemicals, and genetic causes like alpha-1 antitrypsin deficiency.

What is a common presentation for COPD?

Age 50 to 60 onset, excessive productive cough, shortness of breath, chronic symptoms for over 10 years, wheezing, pursed lip breathing, cyanosis, clubbing, muscle wasting, accessory breathing muscle use and possible lower extremity edema.

What is air trapping?

Results from inability to fully exhale due to airway collapse from inflammation or damage to alveoli, leading to trapped air/CO2.

What is forced expiratory volume (FEV1)?

A measure indicating impaired gas exchange due to obstruction and inflammation, visible in spirometry, leads to air trapping

What is the pink puffer COPD presentation?

Rare cough with scant clear sputum, recent weight loss, main complaint is dyspnea, no adventitious breath sounds or peripheral edema.

What is the blue bloater COPD presentation?

Chronic cough with purulent sputum, presents younger, frequently overweight, cyanotic, peripheral edema, wheezing and other adventitious breath sounds

What is the main method of diagnosis for COPD?

Spirometry: a pulmonary function test.

What other tests are used for COPD diagnosis?

Echocardiogram, chest X-ray, chest CT, and blood gas measurement.

What do you expect to see in X-rays of COPD patients?

Increased dark areas due to air trapping and a flattened diaphragm.

What are complications from COPD?

Pneumonia, pulmonary hypertension, right-sided CHF (cor pulmonale), chronic respiratory failure, and atelectasis.

What is atelectasis?

Partial lung collapse.

What is the treatment for COPD?

Oxygen therapy, inhaled bronchodilators or corticosteroids, pulmonary rehab including structured exercise, breathing techniques, counseling, and smoking cessation.

What is the prognosis for COPD?

Mortality can be secondary to comorbidities such as CVD, lung cancer, pneumonia, pulmonary embolism, or acute respiratory failure.

What is pulmonary hypertension?

High blood pressure in the pulmonary arteries.

What are symptoms of pulmonary hypertension?

SOB w/ exertion, chest pain, dizziness, syncope, lower extremity edema, cyanosis, heart palpitations, and fatigue.

How is pulmonary hypertension diagnosed?

Chest X-ray showing right ventricular enlargement and engorged pulmonary arteries. EKG, and blood tests of natriuretic peptide levels.

What are the five kinds of pulmonary hypertension?

1. Pulmonary arterial hypertension, 2. Left heart disease, 3. Lung disease/hypoxia (possibly COPD), 4. Chronic thromboembolic pulmonary hypertension, 5. Miscellaneous (e.g., sarcoidosis).

What is Cystic Fibrosis (CF)?

A genetic condition affecting exocrine glands, causing respiratory issues (lung congestion) and gastrointestinal problems (malabsorption of nutrients).

What is CFTR?

Cystic fibrosis transmembrane conductance regulator, a protein mutation on chromosome 7 causing cystic fibrosis

What is the pathophysiology of cystic fibrosis in the respiratory tract?

Increased viscosity of mucus secretions leads to inflammation, bacterial infections, airway damage, and bronchiectasis - leading to pulmonary hypertension and R-sided HF

What is the pathophysiology of cystic fibrosis in the gastrointestinal tract?

Compromised pancreatic exocrine function leads to malabsorption of nutrients and impacts the hepatobiliary system, intestines, and pancreas.

What are symptoms of cystic fibrosis in infants and children?

Meconium ileus, respiratory symptoms, and failure to thrive.

What are symptoms of cystic fibrosis in adults?

Chronic lung disease history -especially bronchiectasis, infertility, low BMI/malnourishment.

How is cystic fibrosis diagnosed?

Newborn screening blood test, sweat chloride test, pancreatic elastase levels in stool, and respiratory assessments.

What is the treatment for cystic fibrosis?

CFTR modulators, airway clearance, nutritional support, antibiotics, and lung transplant.

What is the prognosis for cystic fibrosis?

Outcomes are improving; median age at death was 33.9 years but now median predicted survival for children born in 2021 being 65.6 years.

What is bronchiectasis?

Chronic lung disease affecting large bronchi, causing permanent dilation and destruction of bronchial walls. 50% cases = CF

What are signs and symptoms of bronchiectasis?

Chronic cough with thick purulent sputum, pleuritic chest pain, SOB, weight loss, hemoptysis, crackles, and wheezing.

How is bronchiectasis diagnosed?

CBC with differential, IgE, IgM, IgA levels, sputum culture, and pulmonary function tests.

What are causes of bronchiectasis other than CF?

Lung infections, immunodeficiencies, alpha-1-antitrypsin deficiency, and primary ciliary dyskinesia.

What is the treatment for bronchiectasis?

Antibiotics if bacterial, airway clearance, and inhaled bronchodilators.

What are complications from bronchiectasis?

Hemoptysis, pulmonary hypertension, R-sided HF, and amyloidosis.

What is pneumothorax?

Collection of air/CO2 which has leaked into pleural space causing lung collapse from the OUTSIDE IN

What are causes of pneumothorax?

Blunt/penetrating chest injury, mechanical ventilation, and damage to the lung from underlying disease.

What are signs and symptoms of pneumothorax?

Sudden onset chest pain, severe shortness of breath, shallow breathing, tachycardia, low oxygen levels, and asymmetrical breath sounds.

How is pneumothorax diagnosed?

Chest X-ray, CT scan, or ultrasound.

What is the treatment for pneumothorax?

Small pneumothoraxes may heal on their own; otherwise, needle aspiration, chest tube insertion, or surgery may be required.

What is Tension Pneumothorax?

A life-threatening medical emergency where air from a ruptured lung enters the pleural space without escape, causing lung compression.

what is atelectisis?

part of lung collapses due to alveoli not filling with air due to blockages, happens from INSIDE OUT

What are the causes of atelectasis?

Airway obstruction and fluid in the pleural cavity (pleural effusion).

What are signs and symptoms of atelectasis?

Dyspnea, chest pain, cough, and mild cases may be asymptomatic.

How is atelectasis diagnosed?

Chest X-ray, CT, MRI, ultrasound, or bronchoscopy.

What is the treatment for atelectasis?

Loosening mucus in the airways, breathing exercises, bronchoscopy to remove blockage, draining, and treating underlying conditions.