Case Study Discussion

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1 Case Study Discussion Student’s Name Institution Course Professor’s Name Date

2 Case Study Discussion A 52-year-old man presents to your office for an acute visit because of coughing and shortness of breath. He is well known to you because of multiple office visits in the past few years for similar reasons. He has a chronic "smoker's cough," but reports that in the past 2 days his cough has increased, his sputum has changed from white to green in color, and he has had to increase the frequency with which he uses his albuterol inhaler. He denies having a fever, chest pain, peripheral edema, or other symptoms. His medical history is significant for hypertension, peripheral vascular disease, and two hospitalizations for pneumonia in the past 5 years. He has a 40-year history of smoking and continues to smoke two packs of cigarettes a day.  What is the probable diagnosis?  What are other possible diagnoses?  At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why? Probable Diagnosis The patient had symptoms that were consistent with having chronic obstructive pulmonary disease (COPD). The hallmark symptoms of acute COPD onset include coughing too much and producing green sputum. This patient is well-known because of his numerous visits over the last two years, and they have satisfied the criteria for this ailment, which is characterized as a productive cough lasting more than three months over the course of a two-year period. Other Diagnoses Inflammation and persistent lung damage are hallmarks of this group of diseases (Anzueto & Miravitlles, 2018). The most common forms of COPD are emphysema and chronic

3 bronchitis. Because of the chronic nature of these disorders and the recurrence of symptoms throughout the patient's lifetime, regular medical monitoring and symptom management are essential (Iheanacho et al., 2020). Dyspnea and frequent usage of an albuterol inhaler raise the possibility of an asthma diagnosis. Asthma and chronic obstructive pulmonary disease (COPD) have certain symptoms, although they are not identical. Patients may have an asthma attack at a young age, and the condition is not always related to tobacco use. Moreover, asthma is usually controllable, and patients' lung function may recover to normal even after occasional exacerbations. However, COPD is often a late-life consequence of extensive cigarette usage. In addition, COPD is an incurable progressive disease that causes a persistent decline in respiratory function. Diagnostic Studies and Treatments Some of the suggested therapies for COPD exacerbation include antibiotics, bronchodilators like albuterol, and systemic corticosteroids (Parris et al., 2019). Serious worsening in a short amount of time of COPD is often treated with symptomatic alleviation as the first line of treatment. Therefore, a combination of medications, including bronchodilators and corticosteroids, is used to open up the airways and make coughing up the viscous sputum less of a pain. Because of the delayed onset of their effect, bronchodilators are often used in conjunction with corticosteroids to hasten the reduction of inflammatory responses (Parris et al., 2019). The ones that move really quickly. Treatment for an acute exacerbation of COPD may be enhanced by combining steroid and bronchodilator treatments, as has been shown. Bed rest is recommended for this patient since the major goal of treating COPD or acute bronchitis is to offer patient assistance and guarantee a sufficient supply of oxygen (Anzueto & Miravitlles, 2018). The level of oxygenation in all patients in respiratory distress must be determined by a

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4 pulmonary function test, such as pulse oximetry or spirometry. The doctor must also check for hypoxemia signs including cyanosis of the limbs. The next step is to do further diagnostic tests, such as a COPD assessment test (CAT), arterial blood gas measurement, CT scan and chest x- ray. Other possible respiratory problems, such as lung cancer or TB, may be ruled out with the use of these tests. Heart failure and other inherited conditions could also be ruled out.

5 References Anzueto, A., & Miravitlles, M. (2018). Considerations for the correct diagnosis of COPD and its management with bronchodilators. Chest , 154 (2), 242-248. Iheanacho, I., Zhang, S., King, D., Rizzo, M., & Ismaila, A. S. (2020). Economic burden of chronic obstructive pulmonary disease (COPD): a systematic literature review. International journal of chronic obstructive pulmonary disease , 439-460. Parris, B. A., O’Farrell, H. E., Fong, K. M., & Yang, I. A. (2019). Chronic obstructive pulmonary disease (COPD) and lung cancer: common pathways for pathogenesis. Journal of thoracic disease , 11 (Suppl 17), S2155.

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