Emphysema
Respiratory (12%) Core Clinical Conditions
1A: Able to diagnose and manage
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Emphysema is a form of chronic obstructive pulmonary disease (COPD). This is a condition where the alveoli ( the air sacs in the lungs) are gradually destroyed, resulting in decreased elasticity and an increase in airspace.
Aetiology
Exposure to air pollution, chemicals and smoking.
Genetic predisposition: deficiency of a protein called alpha-1 antitrypsin (AAT).
Recurrent infections which damage the airways.
Ageing.
Pathophysiology
Gradual damage to alveoli.
Damage causes loss of elasticity of lung tissue.
Air is trapped in the lungs > hyperinflation.
Inflammation in the lungs.
Destruction of lung tissue.
Risk factors
Smoking, air pollution and other environmental causes.
Genetic predisposition.
Ageing.
Repeated respiratory infections.
Male gender.
Sign and symptoms
Cough chronic.
Wheeze, SOB and fatigue.
Repeated chest infections.
Diagnosis and investigations
Physical examination: respiratory examination + pulse oximetry, respiratory rate and capillary refill, smoking history.
Oxygen saturation measurement.
Chest X-ray / CT scan.
Alpha-1 antitrypsin deficiency test.
Bronchoscopy.
Lung biopsy.
Spirometry.
Management
Smoking cessation.
Medications: inhalers (check local guidance), corticosteroids or antibiotics (if evidence of infections).
Chest physiotherapy.
Oxygen therapy.
Vaccination (pneumonia + flu) to prevent respiratory infections.
Lung surgery.
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