COPD

DEF
  DISEASE STATE CHARACTERISED BY CHRONIC AIR FLOW LIMITATION WITHOUT FULL REVERSIBlity


CLASSIFICATION
1 CHRONIC bronchitis  ( Cb )
     a simple
     b chr mucoplurlent
     c chr obstructive
2 emphysema ( Em )
     a centriacinar
     b panacinar
                
ETIO              

1 SMOKING
2 AIR POLLUTION
3 INFECTIO
4 OCCUPATION
5 GENETIC. Alpha trypsin def

Pathgenesis


1 hypertropy of br mucous gland

2 lead to more mucous secretion

3 lead to cilliary activity inhibition

4 lead to collectio of mucous

5 lead to infectio and inflam

6 lead t o destructio of br elastic tissue

7 lead to collaps of small airway obstruction and dil of alveoli.

C/f

1 cough with expect
2 dyspnea
3 wheez
4 smoker cough or morning cough:-         :-)mild increase in winter
      :-)frequent exacerbating
      :-)long duration
      :-)hypoxemia lead to resp failure and cor pul

5 purse lip breathing
6 acessory mus working
7 cynosis i.e blue blotter in Cb and
8 pink puffer in Em
9 tremors flapping
10 confusion
11 barrel sh chest
12 sub costal widening
13 hyperesonance
14 ronchi
15 wheze
16 prolong expiratio
17 in ccf loud p2

Investisation

1 pul fun test
    air flow limitation fev1 <70%
2 cxR HYPERlucent lung zone
        flat diaphram and
        tubular heart

3 in act exacerbation ecg show ccf change

4 sputum for gram st . Culture

5 ABG

TREATMENT

A>SHORT TERM

1 low dose o2

2 antibiotic iv amphicillin

3 beta 2 agonist salbutamol

4 aminophili

5 corticosteroid

6 diuretics for ccf

7 anal diazepam

8 ventilator

B>Longterm

1 stop smoking

2 salmetrol inhaler

3 inhal steroid

4 pul rehabil

5 mucolytic

6 long term o2 therapy

7 surgery



Complication

1 recurrent exacerbation
2 rs failure
3 cor pul
4 ccf
5 pneumothorx