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
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<sup>1</sup> α<sub>1</sub>-Antitrypsin deficiency: Memorandum from a WHO meeting. <i>Bulletin of the World Health Organization.</i> 1997;75:397-415. <a href=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2487011/pdf/bullwho00396-0013.pdf><u>PDF</u></a>
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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
Risks smoke tobacco heating cooking fuel occupational dust chemicals fumes genetic developmental abnormalities low birth wt prematurity childhood resp infxn
Exam Exam rarely if ever diagnostic Wheeze doesn t confirm asthma absence doesn t exclude COPD Ankle swelling may signal cor pulmonale
Post BD FEV1 FVC
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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).