Question

In: Anatomy and Physiology

A 150 lb., 63-year-old man is experiencing exertional dyspnea, shortness of breath, mild cyanosis, and marked...

A 150 lb., 63-year-old man is experiencing exertional dyspnea, shortness of breath, mild cyanosis, and marked slowing of forced expiration. He is chronically fatigued from the action of breathing and appears to have a "barrel chest." In addition, he has been a smoker for 40 years. The doctor describes his condition as a "progressive disease that directly affects the site of gas exchange in his lungs."

What treatments would you recommend for this patient?

Solutions

Expert Solution

His features Exertional Dyspnea,Shortness of Breath,Mild Cyanosis, marked slowing of forced expiration ,Fatigue,Barrel chest and history of smoking for 40 years are all suggestive of Chronic Obstructuive Pulmonary disease -Most Probably Emphysema.

Emphysema is the Permanent Enlargement of AirSpaces distal to Terminal Bronchioles accompanied by destruction of their Walls.

Treatment -

1.Cessation of Smoking-Continuation of Smoking causes more complications.

2.Bronchodialators-

Inhaled bronchodialators are preferred-

a) beta-2 agonists-salbutamol

b) anticholinergics- ipratropium, tiotropium

Oral Bronchodialator-Theophylline

In mild cases-Short acting bronchodialators

In severe Cases-Long acting Bronchodialators.

3.Glucocorticoids-Glucocorticoids are used to Prevent Exacerbation of COPD

4.Pulmonary Rehabilitation-Exercises,Educating about the disease,Nutritional Counselling

5.Oxygen Therapy-

Long Term Domiciliary Oxygen Therapy(LTOT)

This is Indicated when PaO2 < 55 mm Hg

Aim:Increase PaO2 > 60 mm Hg

Surgical Intervention-

1.LVRS(Lung volume Reduction Surgery)-

In severe Upperlobe Emphysema,Peripheral Emphysematous Lung tissue is Removed.

2.Lung Transplantation-In Sweriously Advanced Disease


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