By vgreene, 7 April, 2023 General population screening is controversial USPSTF recommends against screening asymptomatic adults w o risk factors GOLD advocates active case finding not screening spirometry
By vgreene, 7 April, 2023 Identifying pts before significant sx develop not shown to improve COPD outcomes or impact mgmt
By vgreene, 7 April, 2023 Asymptomatic pts w o significant exposures probably don t warrant spirometry If pt has risks e g 20 pack yr smoking recurrent chest infxns consider spirometry for early case finding
By vgreene, 7 April, 2023 Confirm dx w spirometry pre post bronchodilator in pts 40 yo w chronic sx and or exposure risk factors If possible test for SARS CoV 2 prior to spirometry PFTs and delay if test is positive If COPD confirmed perform complete assessment see below
By vgreene, 7 April, 2023 Exam Exam rarely if ever diagnostic Wheeze doesn t confirm asthma absence doesn t exclude COPD Ankle swelling may signal cor pulmonale