Presentation on theme: "This lecture was conducted during the Nephrology Unit Grand Ground by Medical Student rotated under Nephrology Division under the supervision and administration."— Presentation transcript:
This lecture was conducted during the Nephrology Unit Grand Ground by Medical Student rotated under Nephrology Division under the supervision and administration of Prof. Jamal Al Wakeel, Head of Nephrology Unit, Department of Medicine and Dr. Abdulkareem Al Suwaida, Chairman of the Department of Medicine. Nephrology Division is not responsible for the content of the presentation for it is intended for learning and /or education purpose only.
COPD COPD Chronic Obstructive Lung Disease الداء الرئوي الساد المزمن Prepared by: SAAD AL-AMRI Medical Student May 2008
What is COPD? Defenition: It is a disease state characterized by presence of air flow obstruction due to chronic bronchitis or emphysema. The air flow limitation is generally progressive.
Etiology Smoking the primary risk factor Long-term smoking is responsible for 80-90 % of cases. Prolonged exposures to harmful particles and gases from: – passive smoke, – Industrial smoke, – Chemical gases, vapors, mists & fumes – Dusts from grains, minerals & other materials Alpha 1-antitrypsin deficiency >>> emphysema
Pathophysiology Exposure to inhaled noxious particles & gases inflammation imbalance of proteinases and anti-proteinases Dilatation & destruction + mucus secretion
Clinical features Hx: Smoker Productive cough Constant Chest tightness in the morning Sputum>>>>>> mucoid If purulent>>>> infection SOB>>>> on exertion – Aggravated by infection, heavy smoking.
On Examination: Inspection: Pt looks dyspnic Use of accessory muscles Burrel shaped chest Palpation Decrease chest expansion Percussion hyper-resonant Loss of normal area for cardiac & liver dullness
Auscultation: – Decreased breath sounds – Normal vesicular breathing but prolonged expiration – Coarse crepitatons>> on both phases
Investigations Baseline ABG: important for assessing patients with severe COPD. Annual monitoring test Detect acute & chronic hypercapnia Respiratory acidosis
Chest X-Ray: – Not sensitive for Dx – To exclude other diseases – Hyper-inflation signs Investigations
Pulmonary function testing (spirometry): – Main method for diagnosing COPD. low FEV1/FVC (< 70%) – Used for classification of COPD severity. Investigations