Fast Five Quiz: COPD Presentation and Diagnosis

Zab Mosenifar, MD


April 27, 2021

It can be difficult to distinguish CHF from COPD. Clinicians should be alert for a history of orthopnea and paroxysmal nocturnal dyspnea, fine basal crackles on chest auscultation, and typical findings on chest radiographs, which are suggestive of a CHF diagnosis. Wheezing can occur in both COPD and CHF.

Bronchiolitis obliterans is seen in younger nonsmokers and in persons with collagen vascular diseases. Characteristic findings include areas of mosaic attenuation on CT scan with no evidence of generalized emphysema.

Peak expiratory flow may be useful as a bedside test for helping to distinguish COPD from CHF. If patients blow ≤ 150-200 mL, a COPD exacerbation is probable, whereas higher flows are suggestive of a CHF exacerbation. Bronchial hyperresponsiveness is also increased in CHF.

Learn more about the differential diagnosis of COPD.


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