Fast Five Quiz: Can You Properly Identify and Treat COPD?

Zab Mosenifar, MD


September 30, 2014

The value of patient history and physical examination was addressed in the 2013 update to the American College of Physicians/American College of Chest Physicians/American Thoracic Society/European Respiratory Society (ACP/ACCP/ATS/ERS) guideline for diagnosis and management of stable COPD. According to the current guideline, a history of more than 40 pack-years of smoking was the best single predictor of airflow obstruction; however, the most helpful information was provided by a combination of the following three signs:

  • Self-reported smoking history of more than 55 pack-years;

  • Wheezing on auscultation; and

  • Self-reported wheezing.

If all three signs are absent, airflow obstruction can be nearly ruled out. COPD is now known to be a disease with systemic manifestations, and the quantification of these manifestations has proved to be a better predictor of mortality than lung function alone. Many patients with COPD may have decreased fat-free mass, impaired systemic muscle function, osteoporosis, anemia, pulmonary hypertension, cor pulmonale, and even left-sided heart failure. Depression is not uncommon in persons with COPD.

For more information on the presentation of COPD, read here.


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