Alex2444

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COPD

• Chronic obstructive pulmonary disease

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Chronic Obstructive Pulmonary Disease (COPD) is a
common, preventable and treatable disease that is
characterized by persistent respiratory symptoms
and airflow limitation that is due to airway
and/or alveolar abnormalities usually caused by
significant exposure to noxious particles or
gases.
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Plan

• 1. Introduction relevance, purpose
• 2. Main part definition, etiology,
  pathobiology, pathology, diagnosis, stages,
  management, pharmacologic and non- pharmaclogic
  treatment
• 3. Conclusions, questions and references.

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COPD Etiology, Pathobiology Pathology
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Factors that influence disease progression
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Diagnosis and Initial Assessment

• COPD should be considered in any patient who has
  dyspnea, chronic cough or sputum production,
  and/or a history of exposure to risk factors for
  the disease.
• Spirometry is required to make the diagnosis the
  presence of a post-bronchodilator FEV1/FVC lt 0.70
  confirms the presence of persistent airflow
  limitation.
• The goals of COPD assessment are to determine the
  level of airflow limitation, the impact of
  disease on the patients health status, and the
  risk of future events (such as exacerbations,
  hospital admissions, or death), in order to guide
  therapy.
• Concomitant chronic diseases occur frequently in
  COPD patients, including cardiovascular disease,
  skeletal muscle dysfunction, metabolic syndrome,
  osteoporosis, depression, anxiety, and lung
  cancer. These comorbidities should be actively
  sought and treated appropriately when present as
  they can influence mortality and hospitalizations
  independently.

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Diagnosis
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Diagnosis
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Choice of thresholds

• COPD Assessment Test (CAT TM )
• Chronic Respiratory Questionnaire (CCQ )
• St Georges Respiratory Questionnaire (SGRQ)
• Chronic Respiratory Questionnaire (CRQ)
• Modified Medical Research Council (mMRC)
  questionnaire

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ABCD Assessment Tool
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Management of Stable COPD

• The management strategy for stable COPD should be
  predominantly based on the individualized
  assessment of symptoms and future risk of
  exacerbations.
• All individuals who smoke should be strongly
  encouraged and supported to quit.
• The main treatment goals are reduction of
  symptoms and future risk of exacerbations.
• Management strategies are not limited to
  pharmacologic treatments, and should be
  complemented by appropriate non-pharmacologic
  interventions.

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Treatment of COPD
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Treatment of Stable COPD
2017 Global Initiative for Chronic Obstructive
Lung Disease
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Non-Pharmacologic Treatment
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Conclusions(Some statistics)

• The National Heart, Lung, and Blood Institute
  (NHLBI) estimates that 12 million adults have
  COPD, and another 12 million are undiagnosed or
  developing COPD
• Estimated that over 210 million people worldwide
  have COPD
• COPD cost the U.S. economy about 32.1 billion,
  in direct and indirect costs in 2002
• A person with COPD dies every five minutes in the
  world
• COPD will be the third leading cause of death in
  the world by 2030

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Questions
2. In GOLDs refined assessment criteria, what is
required for a diagnosis of COPD? A.
Spirometry B. Lung diffusion capacity test C.
Chest x-ray or chest CT scan D. Arterial blood
gas test

• 1. GOLDs updated definition for COPD emphasizes
  which developmental factors?
• A. Respiratory symptoms
• B. Emphysema and chronic bronchitis
• C. Lung tissue and airway abnormalities
• D. A, B, and C
• E. A and C but not B

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4. In GOLDs updated guideline, traditional COPD
ABCD disease severity groups are further
defined by the addition of A. Respiratory
symptoms subgroups B. Exacerbation history
subgroups C. Spirometric grade subgroups D.
Smoking cessation success rates

• 3. Treatment of stable COPD is now based on
  disease impact (symptom burden, activity
  limitations) and risk of progression as
  determined by exacerbations. True or false?
• A. True
• B. False

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References

• The World Health Organization
• http//www.who.int/mediacentre/factsheets/fs315/en
  /
• The COPD Foundation
• http//www.copdfoundation.org/
• The US Department of Health and Human Services
• http//www.nhlbi.nih.gov/health/dci/Diseases/Copd/
  Copd_WhatIs.html
• National Heart Lung and Blood Institute
• http//www.nhlbi.nih.gov/health/public/lung/other/
  copd_breathe.htm
• Center for Disease Control and Prevention
• http//www.cdc.gov/