Respiratory diseases – Chronic Obstructive Pulmonary Disease Pathophysiology & Clinical Findings of the Disease Are the spirometry results consistent with obstructive or restrictive pulmonary disease? What is the most likely pulmonary diagnosis for this patient?
The above spirometry results show that the patient has Obstructive Pulmonary Disease. The symptoms and investigations are suggestive of Chronic Obstructive Pulmonary Disease. Spirometry and clinical findings results helped to reach the diagnosis. The absolute value of spirometry FEV1/FVC was expected to be 81, but the results showed a value of 64, less than 70% which is one of the main requirements of diagnosing COPD, where the value is less than 70% of the expected value.
-
Explain the pathophysiology associated with the chosen pulmonary disease.
The airway in the lung tissue is inflamed, which interferes with oxygen circulation, reducing the airflow in and out of the lungs (Lange et al., 2021). Additionally, there is increased mucus secretion due to the high number of goblet cells and increased size of submucosal glands. This results in scar formation and destruction of the alveolar wall, which causes attachment making it difficult to eliminate carbon (IV) oxide.
-
Identify at least three objective findings from the case that support the chosen diagnosis.
Relevant results that lend to the diagnosis of COPD in the above case scenario include wheezes present at the time of expiration, shortness of breath, and worsening breathlessness.
-
Identify at least three objective findings from the case that support the chosen diagnosis.
Other observations made during examination beyond the patient’s control include wheezes that occur during forced exhalation on both lungs, hyperinflation of lungs bilaterally with a flat diaphragm visible on the chest x-ray, and a flat chest. These subjective and objective findings indicate that the patient suffers from COPD.
Management of the Disease
-
Classify the patient’s disease severity. Is this considered stable or unstable?
The patient’s condition is classified as unstable because of progressive episodes of breathlessness and other comorbidities such as hypertension, atherosclerotic coronary artery disease, and hyperlipidemia. These illnesses lead to disease complications, and their interaction is likely to worsen COPD in the patient after some time and can easily cause death. COPD is at stage 1 according to the Gold Criteria. At this stage, the patient does not realize they have COPD because the symptoms are mild and worsen as time progresses. The Gold Criteria of COPD stage 1 is explained to be an expected value of greater than 80% of forced expiratory volume in a measure of one second (MacLeod et al., 2021). According to the patient’s results, the value falls at 81%, above the predicted value by 1%; therefore, it falls in stage 1 of COPD.