Last reviewed: 13 Oct 2024
Last updated: 03 Oct 2024
Summary
Definition
History and exam
Key diagnostic factors
- dyspnea
- cough
- wheeze
- changes in sputum volume/color/thickness
- tachypnea
- cyanosis
Other diagnostic factors
- past medical history of COPD
- tobacco dependence
- past medical history of gastroesophageal reflux/swallowing dysfunction
- malaise and fatigue
- chest tightness
- features of cor pulmonale
- environmental/occupational exposure to pollutants or dust
- change in mental status
- fever
- accessory muscle use
- paradoxical movements of abdomen
Risk factors
- viral infection
- bacterial infection
- gastroesophageal reflux/swallowing dysfunction
- smoking
- atypical bacterial infection
- air pollutants
- change in weather
Diagnostic tests
1st tests to order
- oxygen saturation on pulse oximetry
- chest x-ray
- ECG
- ABG
- CBC with differential
- eosinophil count
- C-reactive protein
- basic metabolic panel for electrolytes, BUN, + creatinine
Tests to consider
- sputum culture + Gram stain
- respiratory virus diagnostics
- cardiac troponin
- B-type natriuretic peptide (BNP)
- CT scan of chest
Treatment algorithm
Contributors
Expert advisers
Carolyn L. Rochester, MD
Professor of Medicine
Yale School of Medicine
New Haven
VA Connecticut Healthcare System
West Haven
CT
Disclosures
CLR serves on the COPD scientific advisory board for GlaxoSmithKline Pharmaceuticals but has no competing interests pertaining to this publication.
Richard A. Martinello, MD
Associate Professor
Yale School of Medicine
New Haven
CT
Disclosures
RAM declares that he has no competing interests.
Peer reviewers
Antonio Anzueto, MD
Professor of Medicine
University of Texas Health
Section Chief
South Texas Veterans Health Care System
San Antonio
TX
Disclosures
AA has been a consultant for GlaxoSmithKline, AstraZeneca, Boehringer-Ingelheim, Theravance and Grifols. AA has been reimbursed for his services by these companies. AA is a member of the GOLD scientific committee.
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