Case Study on Copd

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This is a case study on a 76 year old man.Mr Alan Chari(pseudonym used to protect the identity of a patient),was admitted over night in my department.He is a divorcee who stays with son.He is a retired teacher and his son is permanently employed by a local company as an electrician.He is independent with activities of daily livings but is occasionally limited by his ill health.He used to be a heavy smoker .After realising the burden COPD has on general New Zealand population ,affecting about15% of the adult population over the age of 45 years according to asthmanz( 2010) ,l took this case study to gain in-depth understanding. 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) affects hundreds of thousands of Kiwis and it has a substantial impact on the health of New Zealanders. More than 85% of the burden of COPD arises from tobacco smoking, with contributions from cannabis use and dust exposure in the workplace.COPD is the 4th leading cause of death after cancer, heart disease and stroke.COPD is ranked 2nd in men and 5th in women with regards to its health impact.Is estimated to cost up to $192m in direct health care costs each year.COPD is an irreversible disease but is almost entirely preventable by avoiding exposure to tobacco smoke. Over 15% of all smokers are likely to become affected. http://www.asthmanz.co.nz/copd_in_new_zealand.php

Pathophysiology
Chronic obstructive pulmonary disease (COPD) encompasses a group of lung conditions that cause narrowing of the airways, leading to the shortness of breath and difficulty in breathing. It is a progressive disease in which symptoms worsen with time. Chronic bronchitis and emphysema are the most common forms of COPD. In chronic bronchitis, the lining of the airways is thickened as a result of constant irritation, which leads to an excess secretion of mucous. In case of emphysema, the elasticity of mucous lining is reduced, resulting in the obstruction of airflow. Chronic obstructive pulmonary disease (COPD) is a mixture of chronic bronchitis and emphysema disease processes that together form the complete clinical and pathophysiological picture.Progression of COPD is characterized by the accumulation of inflammatory mucous exudates in the lumens of small airways and the thickening of their walls. These walls become infiltrated by adaptive and innate inflammatory immune cells. Infiltration of the airways with substances such as polynuclear and mononuclear phagocytes and CD4 T cells increases with each stage of disease progression. This is also true for B cells and CD8 T cells, which organize into lymphoid follicles. This chronic inflammatory process is associated with tissue repair and...
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