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Thread: COPD & asthma

  1. #1
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    Default COPD & asthma

    hi all

    does anyone knows who to differentiate CLINICALLY between asthma & COPD ??
    I've done the hx on a pt that is labeled as COPD.. but I'm not convensed. and frankly, I dunno how to build up a dx if a similar case came on my OSCE


    thanks

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    Actually we dont get cases like asthma or COPD in our main exams. Please add extra points which i might have left below!

    COPD seen in elderly people, with H/O smoking, alcohol. Also associated CVS symptoms especially RVF, Pulmonary hypertension!

    ASTHMA any age group, but there will be a definite previous H/O asthmatic attacks, look for triggering factor. Unlike COPD not much involvement of other systems like CVS!

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    Obviously we can differentiate.
    Acute exacerbations in asthma and reversible, history of nebulizer, wheezing etc..
    h/o smoking, cough in copd..actually it encludes emphysema &/ chronic bronchitis...chronic bronchitis is clinical entity while emphysema isn't..
    Reffer to harrison for more.

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    thanks all.

    the thing is that, the pt I took the hx from has a stony dull percussion on his rt side of the chest. and he has pectus excavatum.
    and the vocal fermitus is equal on both sides << not 100% sure of it.

    the stony dullness is what annoys me. it directs me towards plural effusion. but the pt main complain is cough.

    plus he has a nocturnal wheezes. and he uses ventoline. that's why I was concidering asthma.

    he has no hx of smoking and not cyanosed so I think it's not chronic bronchitis.

    I dunno. I'm going to him back tomorrow. if he isn't discharged and look for any doctor to help me


    Actually we dont get cases like asthma or COPD in our main exams
    here Asthma is common case. plus SCD
    it's mostly resp and anemias ( thalasemia & SCD )

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    check x-ray findings to exclude emphysema and pleural effusion..
    any acute excerbations? duration of complains?

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    I'm convensed that he's COPD. he didn't tell me he was a heavy smoker and quit recently


    Vitrag
    his CC is cough and exertional dyspnea of 1 week duration.
    haven't seen the investigations results. since all I'm supposed to care about as a 4th yr student is the hx and the PE =)

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    haven't seen the investigations results. since all I'm supposed to care about as a 4th yr student is the hx and the PE =)
    As a 4th yr student, you'll be given classical cases in exams usually..Rest depends on luck.
    So don't hasitate to check reports if you get any confusion.. It'll help you in theory also in remembering Ix and mamagement protocol in your institute..

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