4. COPD
Chronic Bronchitis
● Persistent or recurrent excess of secretion in the
bronchial tree on most days for at least 3 months
in the year, over 2 years
○ Mucous gland hyperplasia
● Risk factors
○ Cigarette smoke
○ Air pollution
○ Dust exposure - cadmium
○ Infection
Emphysema
● Characterised by abnormal, permanent
enlargement of the airspaces distal to the
terminal bronchioles, and destruction of their
walls without fibrosis
○ Loss of elastic recoil
○ Airway narrowing
● 3 morphological patterns
○ Centriacinar
○ Panacinar
○ Paraseptal
5.
6. COPD Exacerbation - COPD X
● Usually multifactorial
○ Infection - viral, bacterial
○ Medicine non-compliance
○ Iatrogenic
● History
● Exam
● Bloods +/- ABG
● ECG
● PFTs
● CXR
Management
● O2
○ Controlled via Venturi if CO2 retainer
○ Otherwise high dose via face mask
● Nebulizers
● Steroids
● Antibiotics
● Diuretics
● BiPAP
7.
8. Asthma
● Hyperreactive airways leading to episodic,reversible bronchoconstriction, owing to increased
responsiveness of the tracheobronchial tree to various stimuli
○ Atopic
○ Non-atopic
● Non-specific triggers
○ Exercise
○ Cold air
○ Emotional distress
○ Aspirin/NSAIDs
9.
10.
11. Asthma Presentation
1. History
a. Precipitating factors
b. Previous attacks
c. RF - ICU, Comorbidities, Compliance
2. Exam
a. Inspection
b. Vitals
c. Auscultation
d. PEF/FEV
3. Investigations
a. Bloods/ABG
b. CXR?
Initial Management
● Position
● O2
● Salbutamol nebs
● Ipratropium nebs
● Steroid
● IVH - insensible losses
