2. MAIN SYMPTOMS OF COPD
• Cough
• Sputum production
• Exertional dyspnea
3. On physical findings
• Odor of cigarette smoke or nicotine staining of fingernails (active smoker)
• Expiratory wheezing
• Cor pulmonale
• Exhibit use of accessory muscles of respiration
• Signs of hyperinflation : a barrel chest and enlarged lung volumes with poor
diaphragmatic excursion
• Sitting in the characteristic “tripod” position
• Cyanosis
• Emphysema :“pink puffers,” thin and noncyanotic at rest , prominent use of
accessory muscles,
• Chronic bronchitis : heavy and cyanotic “blue bloaters”
• Cachexia
• Hoover’s sign
1.Copd should be suspected age over 40y/o
2.Hemoptysis may complicate exacerbation of copd and must do investigation to rule out other problem
Cor pulomonale is misnomer as right heart seldom fails in copd and occurrence of edema d/t failure sodium and water excretion by hypoxic hypercapnic kidney.