Diagnosis and Investigations - Sarah

Diagnosis and investigations of COPD
Diagnosis
Patients with COPD usually are current or past smokers over the age of 40 with a history of shortness of breath upon physical exertion and chronic productive cough. The physical examination may show a barrel chest, decreased breath sounds, and wheezing. Signs of right-sided heart failure, such as oedema, tender liver, and distended abdomen (caused by fluid accumulation in the abdomen; called ascites) may be noted as well. COPD is a diagnosis of history (in the case of chronic bronchitis), or a diagnosis of anatomy (in the case of emphysema). Clubbing of the fingers rarely occurs in COPD and warrants investigation for other causes.

Investigations
• Spirometry -
• Pre- and post-bronchodilator – to rule out asthma
• Resting oxygen saturation measurement suggested in moderate or severe disease
• Arterial blood gas (ABG) measurement recommended in moderate or severe disease or if oxygen saturation is less than 92%.

References
http://www.pulmonologychannel.com/copd/diagnosis.shtml
www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_Diagnosis.html
Netters Clinical Anatomy