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Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is a progressive abnormal inflammatory response of the lungs to noxious particles or gasses. It is estimated that as much as 90% of COPD is due to cigarette smoking with the remainder being due to environmental, occupational or genetic factors. Because of the relationship to various exposures, it is rare for patients less than 35 years of age to develop COPD. The symptoms of COPD vary from person to person however commonly patients will experience chronic cough, sputum production, shortness of breath and decreased exercise tolerance. The physical exam may reveal wheezing amongst other subtle findings however it may be useful in ruling out other alternative diagnoses. Chest x-ray findings may show hyperinflation while CT scan images may reveal changes in the lungs themselves. Spirometry, a special pulmonary test that measures the volume and flow of a breath is often needed to confirm the diagnosis. Similar to asthma, the severity of symptoms and the spirometry results will guide treatment. Smoking cessation is very important as is avoidance of other occupational or environmental exposures. Rescue inhalers, such as albuterol, may be required on an as needed basis. With more severe symptoms or disease, patients may require controller inhalers. Some patients may require supplemental oxygen. In some situations surgery or transplant may be helpful. Also, like asthma, acute exacerbations can be life threatening requiring intensive care level monitoring and treatment.

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Littner MR. In The Clinic: Chronic Obstructive Pulmonary Disease. Ann Intern Med. 2011. Apr 5; 154 (7)