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
By vgreene, 7 April, 2023 Risks smoke tobacco heating cooking fuel occupational dust chemicals fumes genetic developmental abnormalities low birth wt prematurity childhood resp infxn
By vgreene, 7 April, 2023 Hx progressive persistent dyspnea worse w exercise Chronic cough may be intermittent unproductive or absent w or w o chronic sputum any pattern Sx may vary day to day Dyspnea cough sputum may precede airflow limitation by yrs Airflow limitation may exist
By vgreene, 7 April, 2023 GOLD. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2024 Report.