COPD core symptoms & hx findings
COPD is a chronic lung disease that presents with chronic progressive dyspnea, cough, and sputum production
Expiratory wheezing may be present due to bronchospasm or airway narrowing.
In the advanced stages of the disease, COPD can lead to chronic hypoxia and pulmonary hypertension, leading to right-sided heart failure (Cor pulmonale). In such cases, patients may develop weight loss and signs of right-sided heart failure (e.g. peripheral edema, jugular venous distention, hepatomegaly). Imaging in patients with COPD may reveal hyperinflated lung fields (>10 visible posterior ribs above the level of the diaphragm) and a flattened diaphragm.
smoking history.
hyperinflated lungs and flattened diaphragm on chest radiograph
Congestive heart failure signs and symptoms
pedal Edema
orthopnea, paroxysmal nocturnal
dyspnea, and crackles or rales on lung auscultation)
This patient with a 40-pack-year smoking history presents with an 8-month history of worsening dyspnea, cough, wheezing, hypoxia, and bilateral expiratory wheezing. These findings along with an FEV1/FVC ratio < 0.7 with minimal reversibility after bronchodilator administration are mostly consistent with the diagnosis of?
COPD
A 67-year-old man is brought to the emergency department by his partner after being found down at home with several open pill bottles around him.
According to the partner, “He has been so depressed recently, I hope he did not try to hurt himself.” Past medical history includes heart failure, hypertension, atrial fibrillation, diabetes, and major depressive disorder. Home medications include escitalopram, metoprolol, metformin, and digoxin. Temperature is 35.6°C (96.1°F), pulse is 32/min, respirations are 7/min, blood pressure is 72/40 mmHg, and oxygen saturation is
88% on room air. On physical examination, the patient is obtunded, and the extremities are pale and cool to touch. An electrocardiogram demonstrates sinus bradycardia.
What is the patient most likely experiencing?
beta Blocker overdose
