COPD
Incidental findings
+ve signs Tracheal tug, hyperinflation, accessory muscles, hyper-resonant, quiet breath sounds
Differential diagnosis COPD
Function CO2 retention, pul hypertension
Tests FBC – polycythaemia
ABG – hypoxia, CO2 retention
PFT – obstructive, reduced gas transfer
CXR – rule out infection / mass lesion
Causes
Smoking (mixed)
Alpha 1 antitrypsin (panacinar)
Coal dust (centrilobular)
Extensions
Look for splenomegaly (amyloidosis)
Notes

  • Emphysema = abnormal permanent enlargement of airway distal to terminal respiratory bronchiole
  • Chronic bronchitis = productive cough at least 3 months a year 2 sucessive years
  • Indications LTOT: FEV1<1.5, P02<7.3, not smoking
  • Indications lung transplant (in general): <60, endstage lung disease, life expectancy 12-18 months
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