COPD (Chronic Obstructive Pulmonary Disease)
Introduction
COPD (Chronic Obstructive Pulmonary Disease) are commonly used clinical terms for a group of pathological condition in which there is chronic partial or complete obstruction to the airflow at any level from trachea to the smallest airways resulting in functional disability of the lungs, they are diffuse lungs disease four entities are included in COPD.
Chronic Bronchitis
Emphysema
Bronchial asthma
Bronchiectasis
Chronic Bronchitis
Persist cough with expectoration
At least three month of the year for 2 or more year
More common in middle age and in male than female
Etiology
Smoking 4-10 time in a day
Atmospheric pollution
Occupation
Infection
Familial & genetic factor
Clinical features
Morning catarrh worst in winter
Recurrent respiratory infection are common
Dyspnoea on exertion
Cyanosis & oedema
Features of RHF (right heart failure) are common
Chest X-ray shows enlarged heart with prominent vessels
Emphysema
Permanent dilatation of air space distal to the terminal bronchioles & the destruction of walls
It classify in to 5 types
Centriacinar
Panacinar
Paraseptle
Irregular
Mixed
Etiology
Clinical feature
Long history of slowly increase sever exertional dyspnoea
Chest is barrel shaped and hyper resonant
Weight loss is common
Cough occur late after dyspnoea starts and is associated with scanty mucoid sputum
Bronchial asthma
Cause by increase responsiveness of tracheobronchial tree
Wide spread spasmodic narrowing of the air passage
Its episodic disease manifested by paroxysms of dyspnoea, cough and wheezing
Etiology
Family history of allergic disease
hyper sensitive
Occupation (inhaled gases, dust etc.)
Virus (intrinsic asthma)
Precipited by cold, exertion and emotional stress
Clinical feature
Paroxysms of dyspnoea cough wheezing
Most attacks typically last for few minutes to hours
When attacks results in more serious condition called status asthmaticus
More chronic cases may developed corpulmonale
Bronchiectasis
Abnormal and irreversible dilatation of bronchi and bronchioles (more than 2mm)
Inflammatory weakening of the bronchial walls
Persistent cough with expectoration of copious amount of foul smelling purulent sputum
In childhood or early adult life
Etiology
Hereditary and congenital factors
Congenital bronchiectasis
Cystic fibrosis
Hereditary immune deficiency disease
Immotile cilia syndrome
Obstruction
As secondary complication
Clinical feature
Chronic cough with foul smelling sputum production
Haemoptysis and recurrent pneumonia
Sinusitis
In chronic case clubbing of finger metastatic abscess amyloidosis and corpulmonale.
