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CR - COPD (ii) (Clinical presentation (narrow airways -> hyperinflated…
CR - COPD (ii)
Clinical presentation
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pursed lip breathing (inhale through nose, exhale through pursed lips - eases SOB)
decreased breath sounds, wheeze, rhonci
clinical course
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Dx in 50s-60s, but process starts much earlier
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Types of Emphysema
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centriacinar
central/proximal part affected, sparing distal alveoli
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distal acinar
distal part affected, which is adjacent to pleura (hence most often associated with pneumothorax)
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GOLD initiative
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1
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decrease risk factors, vaccines, add short-acting bronchodilator if needed
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4
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add longterm O2, consider surgery
Genetic factors
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mutations in TNF, microsomal epoxide hydrolase, glutathione-S-transferase, MMP12, IL4RA
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