Chronic Obstructive Pulmonary Disease (COPD) Lecture Notes

Overview

• COPD: Chronic Obstructive Pulmonary Disease
  • C for Chronic Air Trapping: Reduced gas exchange due to inflammatory lung damage
  • C for CO2 High: Limited airflow, inability to exhale fully, leading to air trapping and high CO2
• Difference from Asthma:
  • Asthma: Reversible attacks
  • COPD: Irreversible damage to alveoli and bronchi, progresses over years, mainly caused by smoking

Causes and Risk Factors

• Primary Risk Factor: Smoking
  • Referred to in exams as "chronic destruction of the lungs"
• Secondary Risk Factors:
  • Long-term exposure to respiratory irritants
    • Occupations such as car mechanics (chemical fumes) or Wildland firefighters (dust and smoke)
• Notable Risk Factor: Smoking for more than 30 years (as per Kaplan)

Pathophysiology

• Types of COPD:
  • Emphysema (Pink Puffer):
    • Well perfused (pink appearance)
    • Difficulty breathing (puffer)
    • Damage to alveoli, loss of lung elasticity and surfactant
    • Air trapping in lungs
  • Chronic Bronchitis (Blue Bloater):
    • Cyanotic (blue appearance)
    • Inflammation and smooth muscle hypertrophy in bronchi
    • Excessive mucus production
    • Chronic cough and recurring infections

Signs and Symptoms

• Emphysema (Pink Puffer):
  • Acronym: PINK
    • P: Pink skin and pursed-lip breathing
    • I: Increased chest size (barrel chest)
    • N: No or minimal chronic cough
    • K: Keep on tripoding for air exchange
  • Percussion: Hyperresonance (air trapping)
• Chronic Bronchitis (Blue Bloater):
  • Acronym: BLUE
    • B: Big and blue skin (cyanosis)
    • L: Long-term chronic cough and sputum
    • U: Unusual lung sounds (crackles and wheezes)
    • E: Edema (peripheral)

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