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Chronic Obstructive Pulmonary Disease and Emphysema

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Chronic obstructive pulmonary disease (COPD) usually describes a mixture of chronic bronchitis and emphysema. It is characterized by airflow limitation that is not fully reversible, ...

DIAGNOSIS

HISTORY

  • Discuss patient’s use of tobacco and cannabis.

  • Consider indoor pollution (coal furnace) (4).

  • Review possible causes of exacerbation (e.g., recent infection) and history of cough, sputum...

TREATMENT

GENERAL MEASURES

  • Smoking cessation: This is the most important intervention to decrease risk (1,2)[A].

  • Aggressive treatment of infections (3)[B]

  • Treat any reversible bronchospasm.

  • Home oxygen: m...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • May taper or stop oral steroids as outpatient

  • If pneumonia caused exacerbation, need to follow CXR or chest CT until clear or stable

  • Pulmonary rehabilitation for ex...

REFERENCES

1
1 Qaseem A, Wilt TJ, Weinberger SE, et al. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physi...

SEE ALSO

Bronchitis, Acute 

CODES

ICD10

  • J44.9 Chronic obstructive pulmonary disease, unspecified

  • J43.9 Emphysema, unspecified

  • J42 Unspecified chronic bronchitis

  • E84.0 Cystic fibrosis with pulmonary manifestations

  • J47.9 Bronchiectasis...

CLINICAL PEARLS

  • Consider screening PFTs on any high-risk patient.

  • Overnight oximetry if daytime SaO2 is borderline.

  • Influenza/pneumococcal vaccines should be current.

  • Advance directive before patient is ...

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