I. Definition:

Expiratory airflow limitation:

- progressive and associated with an abnormal inflammatory of the lungs to noxious gas (cigarette smoking,…).

- Not fully reversible.

II. Etiology:

- Cigarette smoking (most cases)

- Environmental and occupational dusts, gases,…

III. Pathophysiology:- Include: inflammation, imbalance of proteinases and antiproteinases in the lung, apoptosis, and oxidative stress which be found in the central, peripheral airways and lung parenchyma.

IV. Diagnosis:

1. Clinical presentation and History:

- Dyspnea on exertion gradually progresses over time.

- Cough, sputum production, wheezing, and chest discomfort.

- Smoke cigarette or exposure to environmental risk factor…

- Acute COPD: increased dyspnea, sputum purulence, volume (should search for comorbidities: HF, infection)

2. Physical Examination: shows that Acute respiratory failure, Emphysema, Cor pulmonale (pulmonary hypertension)

3. Laboratory Studies: the main method for diagnosing COPD Spirometry (pulmonary function test) FEV1/FVC < 0.7V.

Classification of severity: is important to treat and manage.

- Acute (severity)

- Chronic (stage)

VI. Treatment:

Should include ongoing assessments, monitoring, education and reduction of risk factors. Focus on both long term goals (improve quality of life; decrease the frequency and the severity of acute; slow progression of disease; prevent morbidity; prolong survival) and treatment of acute COPD.

Questions:

1. Emphysema và chronic bronchitis nên đưa vào định nghĩa hay là chẩn đoán phân biệt? COPD is the final stage of all pulmonary diseases. So, emphysema and chronic bronchitis lead to COPD.

2. Hai bệnh đó là type of copd. Hen thì khác hoàn toàn. Asthma and COPD are completely different from definition and etiology.