All are true about emphysema except:
OPTION A) CLINICAL FEATURE OF EMPHYSEMA SYMPTOMS; The three most common symptoms in COPD are cough, sputum production, and exeional dyspnea. Activities involving significant arm work, paicularly at or above shoulder level, are paicularly difficult for many patients with COPD . the principal feature is worsening dyspnea on exeion with increasing intrusion on the ability to perform vocational or avocational activities. In the most advanced stages- patients are breathless doing simple activities of daily living. CLINICAL FEATURE OF COPD - EMPHYSEMA The classic presentation of emphysema with no "bronchitic" component. Patients barrel-chested and dyspneic, with prolonged expiration, sitting forward in a hunched-over position. In these patients, air space enlargement is severe and diffusing capacity is low. Dyspnea and hyperventilation are prominent, so that until very late in the disease, gas exchange is adequate and blood gas values are relatively normal. Because of prominent dyspnea and adequate oxygenation of hemoglobin, these patients sometimes are sometimes called "pink puffers." CHRONIC BRONCHITIS -emphysema with pronounced chronic bronchitis and a history of recurrent infections. Dyspnea usually is less prominent, and in the absence of increased respiratory drive the patient retains carbon dioxide, becoming hypoxic and often cyanotic .such patients tend to be obese--hence the designation "blue bloaters." OPTION 2) ON PHYSICAL EXAMINATION Early stages of COPD, patients usually have an entirely normal physical examination. More severe disease, the physical examination - prolonged expiratory phase and may include expiratory wheezing. Signs of hyperinflation 1) barrel chest and enlarged lung volumes with poor diaphragmatic excursion as assessed by percussion. 2)Patients with severe airflow obstruction -use of accessory muscles of respiration, sitting in the characteristic "tripod" position to facilitate the actions of the sternocleidomastoid, scalene, and intercostal muscles. 3 CYANOSIS if emphysema with chronic bronchitis Patients may develop cyanosis, visible in the lips and nail beds. 4) SIGN OF ADVANCED COPD cachexia ,significant weight loss, bitemporal wasting, anddiffuse loss of subcutaneous adipose tissue. Clubbing of the digits is not a sign of COPD. The development of lung cancer is the most likely explanation for newly developed clubbing. OPTION C) RISK FACTORS CIGARETTE SMOKING AIRWAY RESPONSIVENESS AND COPD RESPIRATORY INFECTIONS OCCUPATIONAL EXPOSURE. D)COMPLICATION OF COPD- progressive disease is marked by the development of pulmonary hypeension, sometimes leading to cardiac failure, recurrent infections; and ultimately respiratory failure.
Cyanosis
Barrel-shaped chest
Associated with smoking
Type 1 respiratory failure
COPD and Asthma