COPD
What is the most common cause of COPD ?
Long-term exposure to air pollution, secondhand smoke and dust, fumes and chemicals (which are often work-related) can cause COPD. Cigarette smoking being the most common cause.
True or False :
A 45 years old man cannot have asthma.
Justify.
False.
Asthma affects people of all ages .
However, the highest prevalence rate is seen in people of 5 to 17 years of age.
What is pulmonary edema ?
Pulmonary edema is an accumulation of fluid in the alveoli and between alveoli and capillaries which impairs gaseous exchange.
What's an embolus ?
An embolus is a clot that forms anywhere in the circulatory system and moves from its point of origin to a distant site and lodges there, obstructing blood flow in that area.
What is hyperventilation?
Hyperventilation is defined as rapid or excessive deep breathing that causes a drop in CO2 level in the blood below normal.
( Low PaCO2 equals low breathing )
Give me 5 signs and symptoms of COPD
- Cough / Sputum production
- Use of accessory muscles / Tripod position
- Wheezing
- Prolonged expiration
- Breathlessness / Tachycardia
- Cyanosis
- Chest pain
- Ankle swelling
- Pursed lips
What can cause an asthma attack?
Attacks may be caused by severe emotional stress, exercise or exposure to allergens.
What do we usually prescribe patients with OAP?
These patients are prescribed cardiac medications and pacemakers.
Note : They are described usually as having " heart problems " and " water in lungs "
Bonus point if you explain correctly what's a pacemaker.
Where does a pulmonary embolism originate from ?
A pulmonary embolism is the formation of an embolus in a vein, usually in the legs or pelvis.
What's a panic attack ?
While hyperventilation can be caused by lung/ brain pathology , systemic illness , pregnancy, sepsis or even anxiety. Hyperventilation syndrome ( panic attack) is a condition that occurs in the absence of other physical problems.
It commonly occurs when a person is experiencing anxiety.
What can worsen COPD's symptoms?
Minor respiratory problems like flu, increased physical activity and any infection, can worsen COPD and make its symptoms worse
True or False:
Asthma patients are usually prescribed nitroglycerin.
False.
Patients with history of asthma are usually prescribed inhalers.
True or False :
One of the signs of OAP is audible Wheezing.
False.
A sign of OAP are crackles and gurgling audible without stethoscope
Wheezing is a sign of COPD and asthma while crackles and gurgling are signs of OAP
True or False :
Pulmonary embolism causes a decrease in the inspiration process.
False.
The inspiration and expiration processes remain intact.
PE cause a decrease in blood flow and gaseous exchange in the affected areas which leads to a compromise in the blood circulation to the lung, thus blood reaching the lungs cannot be oxygenated adequately.
What does an inhaler do ? And to whom is it prescribed ?
Inhalers help relax the muscles that surround the air passages in the lungs, leading to a dilation of the airways and easier movement of air. Thus, inhalers reduce airway resistance, hence, relieving bronchospasm.
Usually COPD and asthma patients are prescribed inhalers.
What is a hypoxic drive ?
The hypoxic drive is a form of respiratory drive in which the body uses oxygen chemoreceptors instead of carbon dioxide receptors to regulate the respiratory cycle.
Unlike healthy individuals who breathe upon increase in levels of CO2, the COPD patients breathe upon decrease in levels of O2.
When PaO2 decreases, the brain receptors are triggered by that decrease so they send a message to stimulate the breathing muscles and thus breathing is triggered.
Give me 5 Signs and Symptoms of asthma:
- Wheezing
- Nasal flaring
- Tachypnea / Tachycardia
- Use of accessory muscles / Tripod position
- Non productive coughing ( no sputum )
- Dyspnea
- Hypoxia / Cyanosis
- Moist skin
- Anxiety
- AMS ( after severe asthma attacks )
Give 5 Signs and Symptoms of OAP :
- Cough with pink sputum
- Inability to speak with full sentences
- Respiratory distress
- Dyspnea
- Rapid, shallow breathing
- Crackles and gurgling
- Use of accessory muscles and tripod position
- Cyanosis
- Distended neck veins
- Swollen lower extremities
- Anxiety
What do we give to PE patients?
These patients are given anti-clotting and antiplatelet medication to maintain blood flow.
We know them as " dawa sayalen " , ex: Pradaxa - Plavix - Xaerlto
What are the causes of PE ?
- Blood clots : After prolonged immobility periods
- Air bubbles : After open neck injuries
- Bone marrow fragments : After a long-bone fracture
- Amniotic fluid : After an " explosive delivery
Explain the difference between chronic bronchitis and Emphysema
Chronic bronchitis is : A chronic inflammation and thickening of bronchial tree leading to excess mucus production in trachea and bronchi which impairs gaseous exchange. ( Surface is decreased thus lower gaseous exchange?)
Emphysema : Permanent enlargement of alveoli due to destruction of alveolar wall and loss of elasticity leading to decrease in alveolar surface area, prolonged expiration and CO2 retention.
What is asthma characterized by ?
Bronchospasm : The airways that connect your windpipe to your lungs are called bronchi. Sometimes the muscles that line (circle) your bronchi tighten and cause your airways to narrow. This is called a bronchospasm, and it limits the amount of oxygen your body receives.
Edema: Swelling of smaller airways caused by inflammation leading to excess mucus production in bronchi which impairs gaseous exchange.
Increased secretion of mucus that causes plugging of the smaller airways.
How does a congestive heart failure lead to OAP?
When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs. As the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs"
Bonus point if you cite the other cause of OAP
Give me 5 Signs and Symptoms of PE :
- Coughing up blood
- Sudden onset of unexplained dyspnea
- Stabbing chest pain
- Cool , moist skin
- Tachycardia / Tachycardia
- Hypoxia / Cyanosis
- Syncope
- Anxiety
- Decrease in BP
How do we administer inhalers ?
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