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Pathology
Umbrella term for emphysema and chronic bronchitis.
Progressive airway obstruction with little to no reversibility
Emphysema: dilatation and destruction of terminal air spaces
Chronic bronchitis: productive cough on most days for at least 3 months of two successive years.
Aetiology
Tobacco smoking, occupational environments, alpha-1 anti-trypsin deficiency
Signs
Tachypnoea, hyperinflated thorax, lip pursing, plethoric, cyanosis, use of accessory muscles, quiet breath sounds.
Symptoms
Cough, sputum production, breathlessness and wheeze
Investigations
Spirometry: Obstructive pattern
Transfer factor: Reduced in emphysema
Chest X-Ray: Hyperinflation, bullae
HRCT: Examines degree of emphysema
Treatment
Smoking cessation, pulmonary rehabilitation, appropriate self management plans (e.g. home steroids and antibiotics). Appropriate oxygen therapy if needed
Prognosis
Only stopping smoking and long term oxygen therapy (LTOT) improve prognosis
Infective exacerbations, pneumothorax, cor pulmonale, pulmonary hypertension, immobility, weight loss, ventilatory failure
Key Facts
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Key References
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