1 / 17

COPD (Chronic Obstructive Pulmonary Disease)

COPD (Chronic Obstructive Pulmonary Disease). Dr. Meg- angela Christi Amores. COPD. Global Initiative for Chronic Obstructive Lung Disease (GOLD) a disease state characterized by airflow limitation that is not fully reversible Includes:

Download Presentation

COPD (Chronic Obstructive Pulmonary Disease)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.


Presentation Transcript

  1. COPD(Chronic Obstructive Pulmonary Disease) Dr. Meg-angela Christi Amores

  2. COPD • Global Initiative for Chronic Obstructive Lung Disease (GOLD) • a disease state characterized by airflow limitation that is not fully reversible • Includes: • emphysema, chronic bronchitis, and small airways disease

  3. COPD • Emphysema • an anatomically defined condition characterized by destruction and enlargement of the lung alveoli • Chronic Bronchitis • a clinically defined condition with chronic cough and phlegm • Small airways disease • a condition in which small bronchioles are narrowed

  4. Risk Factors • Cigarette Smoking • Intensity: pack years (sticks/day for years) • most highly significant predictor of FEV1 • Airway responsiveness • asthma, chronic bronchitis, and emphysema are variations of the same basic disease • Respiratory infections • Remains to be proven

  5. Risk Factors • Occupational Exposures • general exposure to dust at work • coal mining, gold mining, and cotton textile dust • Ambient Air pollution • living in urban compared to rural areas • Remains to be proven • Passive, or Second-Hand, Smoking Exposure • Genetic Considerations

  6. Natural History • Effect of cigarette smoking depends on intensity, timing during growth, basal function

  7. Pathophysiology • Airflow obstruction • Determined by spirometry: FEV1 and FVC • chronically reduced ratio of FEV1/FVC • seldom shows large responses to inhaled bronchodilators • Hyperinflation • "air trapping“ • helps to compensate for airway obstruction

  8. Pathophysiology • Gas Exchange • Nonuniform ventilation and ventilation-perfusion mismatching

  9. Pathology • Large Airway • Cigarette smoking often results in mucous gland enlargement and goblet cell hyperplasia • proportional to cough and mucus production • Small Airways • major site of increased resistance in most individuals with COPD is in airways 2 mm diameter • goblet cell metaplasia and replacement of surfactant-secreting Clara cells with mucus-secreting and infiltrating mononuclear inflammatory cells

  10. Pathology • Lung Parenchyma • destruction of gas-exchanging airspaces • walls become perforated and later obliterated with coalescence of small distinct airspaces into abnormal and much larger airspaces • Macrophages accumulate • Centriacinaremphysema- most frequently associated with cigarette smoking • Panacinaremphysema - usually observed in patients with alpha1AT deficiency

  11. Clinical presentation • History • cough, sputum production, and exertionaldyspnea • exertionaldyspnea, often described as increased effort to breathe, heaviness, air hunger, or gasping, can be insidious • patient's ability to perform them has changed

  12. Clinical presentation • Physical Findings • entirely normal physical examination – early • signs of active smoking, including an odor of smoke or nicotine staining of fingernails • prolonged expiratory phase and expiratory wheezing- more severe • signs of hyperinflation include a barrel chest and enlarged lung volumes

  13. Laboratory Findings • hallmark of COPD is airflow obstruction • Pulmonary function testing shows airflow obstruction with a reduction in FEV1 and FEV1/FVC • lung volumes may increase

  14. Treatment • SMOKING cessation • Bronchodilators • Anticholinergic agents • Beta agonists • Inhaled Glucocorticoids • Oral Glucocorticoids • Theophylline • Oxygen

  15. Treatment • General Medical Care • Pulmonary Rehabilitation • Lung Volume Reduction Surgery • Lung Transplantation

More Related