DR Medhat MRCP

Causes :
1. Smoking (tobacco smooking is responsible for 80% of the risk of developing COPD)
2. Alpha-1 antitrypsin deficiency
3. Other causes (exposure to occupational dust)
Cadmium (used in smelting)
Coal
الفحم Cotton
القطن Cement
األسمنت Grain
الحبوب Clinical picture :
‣ History & symptoms :
1. Long H/O smooking OR +ve family history.
2. Chronic resp. symptoms (DOE ,cough ,recurrent chest infection).
3. Symptoms of acute exacerbation (wheezes,dyspnoea,cough,resp failure
{commonly hypoxic hypercapnic}).
4. May present with cor-pulmonal,polycythemia.
MRC dyspnoea scale
Grade
Degree of breathlessness related to activities
1 Not troubled by breathlessness except on strenuous exercise
2 Short of breath when hurrying or walking up a slight hill
3
4
Walks slower than contemporaries on level ground because of breathlessness,
or has to stop for breath when walking at own pace
Stops for breath after walking about 100 metres or after a few minutes on level
ground
Signs :
5 Too breathless to leave the house, or breathless when dressing or undressing
Chest signs
1. Barrel Chest (increased AP diameter).
2. Tachypnoea.
3. Active use of the accessory resp. muscles of neck & shoulder .
4. Prolonged expiration .
5. Pursed-lip breathing.
6. Wheezes