8. Differential diagnosis between COPD and Asthma – clinical and functional parameters.

Essay 8- DD between COPD and asthma- clinical and functional parameters

• Definitions
• Asthma
• Chronic inflammatory disorder of the airways that causes episodes of airway obstruction, bronchial hyper-responsiveness and airway inflammation
• Obstruction is reversible
• Defined by the history of respiratory symptoms such as wheeze, SOB, chest tightness and cough that vary in intensity and vary over time
• COPD
• Heterogenous lung condition characterised by chronic respiratory symptoms (dyspnea, cough, sputum production and/or exacerbations) due to abnormalities of the airways and/or alveoli that cause persistent and often progressive airflow obstruction
• Characterised by airway obstruction (FEV1 <80% predicted; FEV1/FVC <0.7)
• Onset
• COPD- develops later in life, often after years of exposure to lung irritants (cigarette smoke, occupational dust)
• Asthma- symptoms often begin in childhood (could also occur in adulthood)
• Symptoms
• COPD
• Progressive change in respiratory function, ranging from cough and sputum production to severe respiratory impairment.
• With pulmonary emphysema, there is a proportionate loss of ventilation and perfusion area in the lung
• Chronic obstructive bronchitis is characterized by excessive bronchial secretions and airway obstruction that causes mismatching of ventilation and perfusion
• Dyspnea
• Cough
• Sputum
• Wheeze
• Asthma
• Wheezing
• Breathlessness
• Chest tightness
• Cough that often is worse at night and in the early morning.
• These episodes usually are reversible either spontaneously or with treatment
• Airways narrow because of bronchospasm, edema of the bronchial mucosa, and mucus plugging
• Expiration becomes prolonged because of progressive airway obstruction
• Use of accessory muscles
• Fatigue
• Response to bronchodilators
• COPD- limited response to bronchodilators
• Asthma- bronchodilators provide significant relief
• Functional parameters