Tiêu đề SCA- Resp. Imtiyaz Medical Acad^.pdf ✅

Dr.Amr Ibrahim MB ChB, MD, Alexandria University, Egypt MSc, University of Tsukuba, Japan
▪Case: COPD- New Dx 58 F , smoker, BG of left breast CA, had mastectomy and ChemoRx. Nil regular meds, Allergic to Penicillin Has Recurrent LRTI recently. Had Spiro => FEV1/FVC 57 % , FEV1 48 % of predicted. Chest XR => NAD Came for r/v after spiro to discuss the results.
• Ask about SOB , productive cough (Onset, variability and progression). • R/o Cor-pulmonale: Oedema , any change in your neck • Ask about acute flare up ( 4 ↑ ) • Night symptoms • Any triggers • R/O PE, cardiac and cancer • Number exacerbations or hospitalization in the last year. • Low Mood (chronic condition). • FH of Liver and lung disease. • Social Hx - detailed , ask about work (occupational – asbestos) • Impact on life and work
▪Dx : Clinical + spirometry. ▪ A post bronchodilator FEV1/FVC < 0.7 confirms persistent airflow obstruction. ▪Staging Stage FEV1 Stage 1, mild FEV1 80% of predicted or higher. Stage 2, moderate FEV1 50–79% Stage 3, severe FEV1 30–49% Stage 4, very severe FEV1 less than 30% FU