(A&E) (Peri-Op & Anaesthesia) (GP)

Overview

• Very common progressive disorder characterised by airflow obstruction with little or no reversibility
• Chronic Bronchitis → chronic narrowing of the airways defined clinically as a productive cough on most days for at least 3 months per year for 2 consecutive years
• Emphysema → defined histologically as permanent destructive enlargement of air spaces distal to the terminal bronchioles
• M>F, more common in older people especially >65 yrs old
• Aetiology → Smoking (90% of cases), exposure to air pollution, α1 antitrypsin deficiency (if COPD symptoms in younger patient)

Making Diagnosis

Clinical Features:

• Chronic Cough → usually productive (clear/white sputum), sputum may change (become green/yellow) with exacerbations or infections
• Dyspnoea and Tachypnoea
• Wheeze
• Pursed Lip Breathing
• Barrel Chest → anteroposterior diameter of chest is increased. Suggests hyperinflation.
• O/E → hyper-resonance on percussion, end-expiratory wheezing on auscultation, coarse crackles, reduced breath sounds