Summary
Definition
History and exam
Key diagnostic factors
- dyspnea
- cough
- wheeze
- changes in sputum volume/color/thickness
- tachypnea
- cyanosis
Other diagnostic factors
- past medical hx COPD
- tobacco use
- past medical hx 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
- bacterial infection
- gastroesophageal reflux/swallowing dysfunction
- viral infection
- atypical bacterial infection
- pollutants
- change in weather
Diagnostic investigations
1st investigations to order
- SaO2 on pulse oximetry
- chest radiograph
- ECG
- Arterial blood gas
- CBC with platelets
- electrolytes, BUN, + creatinine
Investigations to consider
- sputum culture + Gram stain
- respiratory virus diagnostics
- cardiac troponin
- CT scan of chest
Treatment algorithm
Contributors
Authors
Associate Professor
Yale University 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.
Associate Professor
Yale University School of Medicine
New Haven
Veterans Health Administration
Office of Public Health
West Haven
CT
Disclosures
RAM declares that he has no competing interests.
Peer reviewers
Professor of Medicine
Division Chief
Pulmonary/Critical Care/Sleep Medicine
University at Buffalo
State University of New York
Section Chief
Pulmonary/Critical Care/Sleep Medicine
VA Western New York Healthcare System
Buffalo
NY
Disclosures
SS declares that he has no competing interests.
Professor
Box Hill Hospital and Monash University
Victoria
Australia
Disclosures
FT declares that he has no competing interests.
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