COPD

Etiology

  • Smoking leads to lung destruction over time, causing irreversible obstruction to air flow
  • When enough damage occurs, patients develop chronic symptoms of SOB, DOE, cough, sputum production
  • Acute exacerbations (~50% of which are caused by bacterial infections) present with sudden worsening of obstruction from combination of: bronchoconstriction, mucosal edema and increased mucous production

Risk Factors

  • > 20 pack yr smoking hx
  • Sometimes second hand smoke contributes
  • Consider alpha-1 anti-trypsin if < 40 and/or without significant smoking hx

Symptoms

  • SOB
  • DOE
  • Sputum
  • Cough
  • Wheezing
  • Acute exacerbation associated w/worsening SOB and colored sputum

Physical Exam Findings

  • Wheezing
  • Can have elevated respiratory rate and significant work of breathing if advanced and/or acutely ill
  • Often diminished breath sounds
  • Sometimes barreled chested
  • Rarely cyanosis and clubbing
  • Weight loss and wasting if very advanced

Tests