Mrs B is a 56 year old lady who presents with dyspnea on exertion that has slowl

Question

Mrs B is a 56 year old lady who presents with dyspnea on exertion that has slowly and progressively gotten worse over the last year. she has had a minor non productive cough. she denies fever, nausea vomiting or night sweats. her past medical history is positive for HTN and hyperlipidemia. her current medication include simvastatin and Lisinopril. she has smoked 1-2 packs of cigarettes daily for 25 years. her vital are remarkable for a respiratory rate of 24 and an oxygen saturation of 89%. upon examination reveals a thin female using pursed lip breathing and tripod positioning, the chest is barrel shaped and lung sounds are markedly diminished but there is faint expiratory wheezes bilaterally. Fingernail clubbing is present bilaterally. her chest x-ray shows hyperinflation.

1. this clinical scenario is most consistent with which diagnosis.
2. what data in this scenario supports your diagnosis.
3. what risk factors led to this diagnosis.
4.what actual or potential complications related to this diagnosis does she need to be monitored.

Explanation / Answer

1. The patient is suffering from COPD chronic obstructive pulmonary disease with carcinoma.

2. Upon examination, the chest is barrel-shaped and lung sounds are markedly diminished but there is faint expiratory wheezes bilaterally. Fingernail clubbing is present bilaterally. chest x-ray shows hyperinflation, therefore it is COPD

3. Clubbing is present bilaterally and she has smoked cigarettes are the risk factors which led to this diagnosis.

4. The patient needs to be monitored for the complication of COPD and Carcinoma

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