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What is LTOT? Who would be eligible? 


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This is Long Term Oxygen Therapy. It is the continuous administration of oxygen via nasal cannula in

order for the patient to maintain >90% oxygen saturations.

Will benefit patients who have a PaO2 of <7.3kPA when breathing air. A PaO2of <8kPA with

secondary polycythaemia, nocturnal hypoxaemia, peripheral oedema or evidence of pulmonary

hypertension. Finally patients who have a carboxyhaemoglobin of <3%.

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What is pulmonary rehabilitation? 
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Pulmonary Rehabilitation (PR) is a treatment programme made up of physical exercise programme, designed for people with lung conditions which is tailored for them. 

It provides patients with information on looking after their lungs and body and gives advice on managing their condition and symptoms.


The course usually lasts 6-8 weeks with 2 sessions a week. They are held in local hospitals, health centres and leisure centres. 

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What are the signs COPD? 

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1. Tachypnoea 

2. Barrel chest 

3. Hyperresonance on percussion 

4. Quiet breath sounds and wheeze 

5. Tar staining of fingers with peripheral cyanosis 

6. Evidence of cor pulmonale (right-sided heart failure due to severe COPD): e.g. peripheral oedema 

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What are the risk factors/ causes of COPD? 

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1. Age: After age of 45 

2. Tobacco smoking 

3. Air Pollution 

4. Occupational Exposure: dust, cadmium (in smelting), coal, cement 

5. Alpha-1 antitrypsin deficiency; younger patients 

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What is COPD? 

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COPD describes progressive and irreversible obstructive airway disease, most commonly caused by smoking. 

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What investigations do we do for someone suspected of having COPD? 


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PRIMARY INVESTIGATIONS: 

- Spirometry and bronchodilator reversibility: FEV1/FVC <0.70 and lack of reversibility post-bronchodilator is a positive result. 

Routine BDR is NOT required for diagnosis as it may be unhelpful or misleading. 

- Chest x-ray: flattened diaphragm, hyperinflation and bullae. Also to see evidence of lung cancer 

- FBC: COPD causes chronic hypoxia which may result in secondary polycythaemia.

- Calculate body mass index (BMI

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What is spirometry? 

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Spirometry measures the volume of air on forceful expiration following maximal inspiration.

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How do we grade airflow obstruction?  

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GOLD classify the severity of airway obstruction using FEV1, as follows: 


Severity of airflow obstruction

Post-bronchodilator FEV1/FVC

FEV1 (% of predicted)

Stage 1: Mild*

<0.70

≥80%

Stage 2: Moderate

<0.70 

50-79%

Stage 3: Severe

<0.70 

30-49%

Stage 4: Very severe

<0.70

<30%

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TESTE DEIN WISSEN

What is the second line investigations for COPD? 

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1. Transfer factor for carbon monoxide (TLCO): Reduced due to impaired gas exchange and performed if symptoms are disproportionate to spirometry results. 


2. Serum alpha-1 antitrypsin: perform when minimal smoking history 

3. ABG: Performed in acutely unwell patients. COPD causes either Type 1/2 resp failure 

4. CT Chest: exclude alternative diagnoses 

4. ECG: evidence of right-sided HF (e.g. right axis deviation, RBBB) 

5. Sputum Culture: sputum is persistent + purulent 

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What are the signs of exacerbation of COPD? 


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- Significant dyspnoea, wheeze and cough 

- Coarse crepitations 

- Pyrexia 

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What is the MRC dyspnoea scale? 

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The MRC dyspnoea scale is used to grade the severity of breathlessness 

1. Breathlessness on strenuous exercise 

2. Breathlessness on hurrying or slight hill 

3. Walks slower than people of the same age on ground level due to breathlessness OR have to stop to catch breath when walking at own pace 

4. Stops to catch breath after walking about 100 metres OR after a few minutes of walking. 

5. Too breathless to leave the house or breathless when dressing/undressing 

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What is cor pulmonale? 

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Cor pulmonale is a condition that causes the right side of the heart to fail. 

Long-term high blood pressure in the arteries of the lung and right ventricles of the heart can lead to cor pulmonale. 

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Q:

What is LTOT? Who would be eligible? 


A:

This is Long Term Oxygen Therapy. It is the continuous administration of oxygen via nasal cannula in

order for the patient to maintain >90% oxygen saturations.

Will benefit patients who have a PaO2 of <7.3kPA when breathing air. A PaO2of <8kPA with

secondary polycythaemia, nocturnal hypoxaemia, peripheral oedema or evidence of pulmonary

hypertension. Finally patients who have a carboxyhaemoglobin of <3%.

Q:


What is pulmonary rehabilitation? 
A:

Pulmonary Rehabilitation (PR) is a treatment programme made up of physical exercise programme, designed for people with lung conditions which is tailored for them. 

It provides patients with information on looking after their lungs and body and gives advice on managing their condition and symptoms.


The course usually lasts 6-8 weeks with 2 sessions a week. They are held in local hospitals, health centres and leisure centres. 

Q:

What are the signs COPD? 

A:

1. Tachypnoea 

2. Barrel chest 

3. Hyperresonance on percussion 

4. Quiet breath sounds and wheeze 

5. Tar staining of fingers with peripheral cyanosis 

6. Evidence of cor pulmonale (right-sided heart failure due to severe COPD): e.g. peripheral oedema 

Q:

What are the risk factors/ causes of COPD? 

A:

1. Age: After age of 45 

2. Tobacco smoking 

3. Air Pollution 

4. Occupational Exposure: dust, cadmium (in smelting), coal, cement 

5. Alpha-1 antitrypsin deficiency; younger patients 

Q:

What is COPD? 

A:

COPD describes progressive and irreversible obstructive airway disease, most commonly caused by smoking. 

Mehr Karteikarten anzeigen
Q:

What investigations do we do for someone suspected of having COPD? 


A:

PRIMARY INVESTIGATIONS: 

- Spirometry and bronchodilator reversibility: FEV1/FVC <0.70 and lack of reversibility post-bronchodilator is a positive result. 

Routine BDR is NOT required for diagnosis as it may be unhelpful or misleading. 

- Chest x-ray: flattened diaphragm, hyperinflation and bullae. Also to see evidence of lung cancer 

- FBC: COPD causes chronic hypoxia which may result in secondary polycythaemia.

- Calculate body mass index (BMI

Q:

What is spirometry? 

A:

Spirometry measures the volume of air on forceful expiration following maximal inspiration.

Q:

How do we grade airflow obstruction?  

A:

GOLD classify the severity of airway obstruction using FEV1, as follows: 


Severity of airflow obstruction

Post-bronchodilator FEV1/FVC

FEV1 (% of predicted)

Stage 1: Mild*

<0.70

≥80%

Stage 2: Moderate

<0.70 

50-79%

Stage 3: Severe

<0.70 

30-49%

Stage 4: Very severe

<0.70

<30%

Q:

What is the second line investigations for COPD? 

A:

1. Transfer factor for carbon monoxide (TLCO): Reduced due to impaired gas exchange and performed if symptoms are disproportionate to spirometry results. 


2. Serum alpha-1 antitrypsin: perform when minimal smoking history 

3. ABG: Performed in acutely unwell patients. COPD causes either Type 1/2 resp failure 

4. CT Chest: exclude alternative diagnoses 

4. ECG: evidence of right-sided HF (e.g. right axis deviation, RBBB) 

5. Sputum Culture: sputum is persistent + purulent 

Q:

What are the signs of exacerbation of COPD? 


A:

- Significant dyspnoea, wheeze and cough 

- Coarse crepitations 

- Pyrexia 

Q:

What is the MRC dyspnoea scale? 

A:

The MRC dyspnoea scale is used to grade the severity of breathlessness 

1. Breathlessness on strenuous exercise 

2. Breathlessness on hurrying or slight hill 

3. Walks slower than people of the same age on ground level due to breathlessness OR have to stop to catch breath when walking at own pace 

4. Stops to catch breath after walking about 100 metres OR after a few minutes of walking. 

5. Too breathless to leave the house or breathless when dressing/undressing 

Q:




What is cor pulmonale? 

A:

Cor pulmonale is a condition that causes the right side of the heart to fail. 

Long-term high blood pressure in the arteries of the lung and right ventricles of the heart can lead to cor pulmonale. 

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