Presenting hx
Chari is a known patient with Chronic obstructive airway disease(COPD).He presented with increased shortness of breath, stabbing chest pain aggravated by breathing, continues coughing,rapid breathing,incresed sputum production(no change in colour),.He is on ventolin inhaler qid prn which he has not been using despite having these symtoms, Also on Seretide 125/25,2 puffs bd and home oxygen for COPD ,Chari has other co morbidities namely ,low body mass index,previous pulmonary emboli(treated).
On examination,he appears frail with evidence of poor nutritional status,He had bibasal crepitations,wheeze throughout the lungs and reduced air entry.His oxygen saturations were 89% on 2litres oxygen
Other tests-blood gas showered a normal ph,and hypoxia(mild).Bloods indicates no raised white cell count.Vital signs,Temperature 37 degrees,BP 120/60,Respirations 24b/min.Weight 52 kg
Chest x-ray showed widespread changes in COPD,ill defined opacity in rt lower lobe which has increased in density in comparison with previous study.No other focal areas of consolidation or collapse identified.In view of this he was prescribed predinisone for 10 days(in tiltrated dosages),He was also encouraged to use his ventolin inhaler prn to gain quick relieve for increased shortness of breaths.
COPD
Chronic Obstructive Pulmonary Disease (COPD)