58 yo female presents to clinic c/w SOB and increasing slowly
for yrs.
Symptoms worse in recent months, last 2 days much worse with
productive cough.
Ankles swelling.
Additional hx:
60 pack-yr; quit 5 yrs. ago
Yellow sputum
No fever, no chills or chest pain
No weight loss
No hx of heart disease
Additional
No TB or asbestos exposure-no occupational exposure
no alleriges
no hx of asthma
occasional bronchitis
What is the differential diagnosis?
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Among patients WHo present in mid or later life with dyspnea, cough, and sputum production, the differential diagnosis is broad (eg, heart failure, COPD, interstitial lung disease, thromboembolic disease) (. Typically, the finding of persistent airflow limitation on pulmonary function testing and the absence of radiographic features of heart failure or interstitial lung disease direct the clinician to a narrower differential of COPD, chronic obstructive asthma, bronchiectasis, tuberculosis, constrictive bronchiolitis, and diffuse panbronchiolitis. Importantly, these conditions can commonly occur together, for example, patients with asthma may develop COPD and patients with COPD may have concurrent bronchiectasis.
58 yo female presents to clinic c/w SOB and increasing slowly for yrs. Symptoms worse in...
58 yo female presents to clinic c/w SOB and increasing slowly for yrs. Symptoms worse in recent months, last 2 days much worse with productive cough. Ankles swelling. Additional hx: 60 pack-yr; quit 5 yrs. Ago Yellow sputum No fever, no chills or chest pain No weight loss No hx of heart disease Additional No TB or asbestos exposure-no occupational exposure no allergies no hx of asthma occasional bronchitis What is the differential diagnosis
58 yo female presents to clinic c/w SOB and increasing slowly for yrs. Symptoms worse in recent months, last 2 days much worse with productive cough Ankles swelling Additional hx: 60 pack-yr; quit 5 yrs. Ago Yellow sputum No fever, no chills or chest pain No weight loss No hx of heart disease Additional No TB or asbestos exposure-no occupational exposure no allergies no hx of asthma occasional bronchitis List all tests you would order?
58 yo female presents to clinic c/w SOB and increasing slowly for yrs. Symptoms worse in recent months, last 2 days much worse with productive cough Ankles swelling Additional hx: 60 pack-yr; quit 5 yrs. Ago Yellow sputum No fever, no chills or chest pain No weight loss No hx of heart disease Additional No TB or asbestos exposure-no occupational exposure no allergies no hx of asthma occasional bronchitis What are the key elements of management for this patient.
58 yo female presents to clinic c/w SOB and increasing slowly for yrs. Symptoms worse in recent months, last 2 days much worse with productive cough. Ankles swelling. Additional hx: 60 pack-yr; quit 5 yrs. ago Yellow sputum No fever, no chills or chest pain No weight loss No hx of heart disease Additional No TB or asbestos exposure-no occupational exposure no alleriges no hx of asthma occasional bronchitis List all test you would order.
58 yo female presents to clinic c/w SOB and increasing slowly for yrs. Symptoms worse in recent months, last 2 days much worse with productive cough. Ankles swelling. Additional hx: 60 pack-yr; quit 5 yrs. ago Yellow sputum No fever, no chills or chest pain No weight loss No hx of heart disease Additional No TB or asbestos exposure-no occupational exposure no alleriges no hx of asthma occasional bronchitis What are the key elements of management for this patient?
58 yo female presents to clinic c/w SOB and increasing slowly for yrs. Symptoms worse in recent months, last 2 days much worse with productive cough. Ankles swelling. Additional hx: 60 pack-yr; quit 5 yrs. Ago Yellow sputum No fever, no chills or chest pain No weight loss No hx of heart disease What would you like to ask about her medical hx?
58 yo female presents to clinic c/w SOB and increasing slowly for yrs. Symptoms worse in recent months, last 2 days much worse with productive cough. Ankles swelling. Additional hx: 60 pack-yr; quit 5 yrs. ago Yellow sputum No fever, no chills or chest pain No weight loss No hx of heart disease What would you lke to ask about her medical hx?
58 yo female presents to clinic c/w SOB and increasing slowly for yrs. Symptoms worse in recent months, last 2 days much worse with productive cough. Ankles swelling. What other questions would you like to ask?
58 yo female presents to clinic c/w SOB and increasing slowly for yrs. Symptoms worse in recent months, last 2 days much worse with productive cough. Ankles swelling. What other questions would you like to ask?
M.E., a 72-year-old white female presents to her local primary care office in January with c/o a worsening, productive cough and increased SOB. She describes the sputum as “a dime size amount that’s thick and yellow every time I cough.” Symptoms began 1 week ago after visiting her daughter in New Mexico and worsened three days ago. Denies sick exposure but did travel by air to visit daughter. She was seen at an urgent care clinic two days prior and...