COPD

1. Airway OBSTRUCTION that is PROGRESSIVE and NOT FULLY REVERSIBLE characterised by chronic bronchitis and emphysema
   1. FEV1:FVC ratio <70% +/- FEV1<80%

1. over the age of 35
2. have a risk factor (generally SMOKING)
3. exertional SOB, chronic cough, regular sputum production, frequent winter 'bronchitis' or wheeze.
4. may also cause abnormal weight loss, effort intolerance and ankle oedema.

Attachments:

• COPD

1. Respiratory distress: tachypnoea, breathlessness on exertion, increased use of accessory muscles of respiration, pursed lip breathing.
2. Abnormal posture: patients may lean forward and rest their arms on the table to ease breathing.
3. Drowsiness, flapping tremor and mental confusion (these are features of elevated carbon dioxide levels).
4. underweight, ankle oedema, cyanosis, hyperinflation of the chest, downward displacement of the liver, relatively quiet vesicular breath sounds, wheezing, prolonged forced expiratory time.

1. right ventricular hypertrophy and cor pulmonale
2. Pneumothorax
3. Type 1 or 2 Respiratory Failure
4. Arrythmias (AF)
5. Infections
6. Secondary polycythaemia

1. Smoking
2. Air pollutions (cooking fuel, exhaust fumes)
3. Occupational dust and chemicals
4. Frequent lower RT infections in childhood

1. Spirometry
2. CXR
   1. CT for any abnormalities
3. FBC (to identify anaemia or polycythaemia)
4. Genetic: alpha-1-antitrypsin (A1AT) deficiency