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cce_family medicine_COPD (investigations (test ((FEV1/FVC <80%…
cce_family medicine_COPD
history
sob exercise tolerance, productive cough, wheeze (smoking)
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investigations
blood
Hb, MCV, acid-base, pO2, PCO2 (hypoxemia, hypercapnia)
test
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(Gram stain, culture, AFB) sputum
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physical examination
respiratory
barrel chest, hyperinflation
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tachypnea, tachycardia, pulsus paradoxus
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respiratory distress (cyanosis, drowsy, expiratory wheezes)
follow-up
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symptoms, inhaler technique
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GOLD
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D: more symptoms, more risks & FEV1 <30% & number of exacerbations per year (long term oxygen)
GOLD
A: less symptoms, less risks & FEV1 80% & number of exacerbations per year (prn: SABA or SAMA)
B: more symptoms, less risks & FEV1 <80% & number of exacerbations per year (LABA or LAMA)
COPD
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vaccinations (influenza, pneumoniae)
explain (chronic, x cure, symptom relieve) (red flag signs)
refer
nurse (concept, technique, compliance)
physiotherapist (chest physiotherapy, postural sputum drainage)
occupational therapist (breathing exercise, diet/exercise)
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grade 3: walk slower, stop after 15 minutes
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grade 5: dress/undress, x leave house
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