Reference no: EM133477795

Problem

Your patient is a 56 year old Caucasian male who has a history of mild to moderate high levels of cholesterol and LDL. He is a 1 pack a day smoker (cigarettes) for the past 25 years and occasionally vapes as well. He is not on a regimented diet. He also states that because of his physical job he is not one to exercise.

Today he is presenting to you with concerns of a cough. Although he has had a intermittent cough for four years this issue increased to a persistent and daily event for the last three months. Our patient claims to have had no previous infections such as pneumonia or tuberculosis. He didn't think much of the cough until recently. Now the cough is productive (clear to white mucous, NO blood), keeping him "up at night" and interfering with his work. Over the last two to three weeks he is also wheezing and more fatigued with non-strenuous walking and light activity.

On physical exam our patient is demonstrating stridor (respiratory sounds on inspiration and expiration) and mild dyspnea. Although he is not in full distress there is evidence of abdominal effort with his respirations. His blood pressure is 123/72 in the office today. There is no murmur or arrhythmia noted at this time however lung field auscultation detects harsh, bilateral wheezing Luckily he is COVID and influenza negative on both an antigen and PCR test.

You order thoracic radiographs and both a cardio/pulmonary stress test along with basic blood work. Based on these tests you tentatively diagnosis our patient with COPD (chronic obstructive pulmonary disease). You also inform him the cardio results indicate concerns of mild cardiac output insufficiency. This issues though will need to be explored in the future with more detailed studies. For now it is time to sit down with your client and discuss your pulmonary concerns.
Please craft a clear concise post to explain to our patient:

A. Define COPD along with possible etiological agents that fit our patient's history. You should also generalize the pathogenesis tying this into your patient's clinical manifestations. Since you completed a radiograph what radiographic signs helped lead you to this diagnosis.?

B. There are two types of COPD - can you explain these subdivisions to our patient? Can you speculate which form defines our patient's clinical signs? Is there a way to prove which form is present?

C. How does our patient's lifestyle promote this disease? Will his suspected heart health due to cholesterol play into the clinical manifestations and pathogenesis of COPD? Do you have any treatment or lifestyle suggestions for our client while he is awaiting further tests?