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WEEK 17:
COPD PLENARY:
| Question | Answer |
|---|---|
| which patients with COPD should be tested for AATD according to WHO | all patients with COPD should be tested once for AATD |
| single most appropriate additional maintenance treatment | inhaled LAMA and LABA |
| what can cause breathlessness | COPD motor neuron disease anxiety lung cancer |
| pulmonary causes of breathlessness | asthma COPD pneumonia pulmonary embolism lung cancer pleural effusion |
| cardiac causes of breathlessness | silent MI cardiac arrythmia acute pulmonary oedema chronic heart failure |
| psychological causes of breathlessness | anxiety psychogenic breathlessness |
| other causes of breathlessness (apart from pulmonary, cardiac, and psychological) | obesity, MND, rib fractures, lung cancer, anaemia, AATD |
| COPD definition | preventable and treatable disease including chronic bronchitis, emphysema and chronic IRREVERSIBLE asthma with FEV1< 100% and FEV1:FVC <70% |
| emphysema | damage to air sacs in lungs |
| chronic bronchitis | long term inflammation of airways |
| symptoms of COPD./ questions to ask to aid diagnosis | chronic cough regular sputum production frequent winter bronchitis wheeze Weight loss Reduced exercise tolerance Waking at night with breathlessness Ankle swelling Fatigue Occupational hazards Chest pain Haemoptysis |
| which drug can cause drug | ramipril |
| which drug can cause ankle swelling | amlodipine |
| when is ankle swelling seen and what does it cause | ankle swelling is seen in bad COPD because it causes right heart failure |
| diagnostic tests | CXR blood (FBC) eGFR |
| size of lungs in COPD | hyperinflation of lungs |
| features of SABA | rapid onset of action (5 mins) and effects last for up to 4 hours |
| what else could you offer apart from drugs to help smokers with COPD | e-cigarettes 12 week NHS programme to quitting smoking nicotine replacement therapy pulmonary rehabilitation |
| cCO monitoring involves | tracks smoking cessation where in 24-48 hours CO levels go back to level of non smoker |
| vaccinations to recommend | annual flu jabs and a pneumococcal vaccination and covid vaccination |
| patient with COPD, smoker, HYPERTENSION what are the first choice oral antibiotics given | Offer 30 mg oral prednisolone once daily for 5 days Amoxicillin 500 mg three times a day for 5 days. Doxycycline 200 mg on first day, then 100mg once a day for 5-day course in total. Clarithromycin 500 mg twice a day for 5 days. |
| pulmonary rehabilitation | physical exercise programme with advice + info on managing COPD from physiotherapists, nurses and occupation therapist lasting 6-8 weeks with 2 session 2 hours each week with 8-16 patients a session- made available to all patients with COPD |
Created by:
kablooey
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