COPD
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Signs
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Tracheal tug, hyperinflation, accessory muscles, hyper-resonant, quiet breath sounds
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Function
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CO2 retention, pulmonary hypertension
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Tests
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FBC - polycythaemia
ABG - hypoxia, CO2 retention
Pulmonary function tests - obstructive picture, reduced gas transfer
CXR - rule out infection / mass lesion
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Causes
Smoking (mixed)
Alpha 1 antitrypsin (panacinar)
Coal dust (centrilobular)
Extensions
Look for splenomegaly (amyloidosis)
Notes
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Emphysema = abnormal permanent enlargement of airway distal to terminal respiratory bronchiole
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Chronic bronchitis = productive cough at least 3 months a year 2 sucessive years
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Indications LTOT: FEV1<1.5, P02<7.3, not smoking
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Indications lung transplant (in general): <60, endstage lung disease, life expectancy 12-18 months
