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Copd Exacerbation

 Syn. COPD Exacerbation flare up , Exacerbation of chronic obstructive pulmonary disease , Acute worsening of COPD symptoms

Signs & Symptoms

 Episodic acute worsening of respiratory symptoms #criteria
Note: Worsening of the patient's respiratory symptoms that is beyond normal day-to-day variations
Ref: Uptodate [ COPD exacerbations: Clinical manifestations and evaluation/ COPD exacerbations: Management] Harrison [ 1997] Cecil [ 189]
Perior experience of COPD exacerbation
Ref: Uptodate [ COPD exacerbations: Clinical manifestations and evaluatio] Harrison [ 1997] Cecil [ 189]
Increased cough #criteria
Note: Worsening of the patient's respiratory symptoms that is beyond normal day-to-day variations
Ref: Uptodate [ COPD exacerbations: Clinical manifestations and evaluation/ COPD exacerbations: Management] Harrison [ 1997] Cecil [ 189]
Increased sputum production #criteria
Note: Worsening of the patient's respiratory symptoms that is beyond normal day-to-day variations
Ref: Uptodate [ COPD exacerbations: Clinical manifestations and evaluation/ COPD exacerbations: Management] Harrison [ 1997] Cecil [ 189]

Physical Examination

 Tachypnea #criteria
Ref: Uptodate [ COPD exacerbations: Clinical manifestations and evaluation/ COPD exacerbations: Management] Harrison [ 1997] Cecil [ 189] Epocrates [ https://online.epocrates.com/diseases/833/Acute-COPD-exacerbation/History-Exam]
Paradoxical chestwall-abdominal movements #criteria
Note: asynchrony between chest and abdominal motion with respiration
Ref: Uptodate [ COPD exacerbations: Clinical manifestations and evaluation/ COPD exacerbations: Management] Harrison [ 1997] Cecil [ 189]
Use of accessory respiratory muscles #criteria
Ref: Uptodate [ COPD exacerbations: Clinical manifestations and evaluation/ COPD exacerbations: Management] Harrison [ 1997] Cecil [ 189]

Lab / Serology

 Change in sputum thickness
Ref: Epocrates [ https://online.epocrates.com/diseases/833/Acute-COPD-exacerbation/History-Exam]
Decreased activity level
Ref: Epocrates [ https://online.epocrates.com/diseases/833/Acute-COPD-exacerbation/History-Exam]
Positive sputum cultures
Note: due to bacterial respiratory infection
Ref: Epocrates [ https://online.epocrates.com/diseases/834/Acute-COPD-exacerbation/Diagnostic-Tests]

Imagin Study

 Respiratory acidosis
Ref: Epocrates [ https://online.epocrates.com/diseases/834/Acute-COPD-exacerbation/Diagnostic-Tests]
Compensatory metabolic alkalosis
Ref: Epocrates [ https://online.epocrates.com/diseases/834/Acute-COPD-exacerbation/Diagnostic-Tests]
Depressed oxygen saturation
Ref: Epocrates [ https://online.epocrates.com/diseases/833/Acute-COPD-exacerbation/History-Exam]

Complication

 Pulmonary hypertension
Note: Both a risk factor for exacerbation and also a complication of copd
Ref: Uptodate [ COPD exacerbations: Clinical manifestations and evaluatio]
Acute respiratory failure
Ref: Harrison [ 1998] Cecil [ 189]
Death
Ref: Cecil [ 189]

Risk Factors

 Elder
Ref: Cecil [ 189]
Smoking
Ref: Epocrates [ https://online.epocrates.com/diseases/832/Acute-COPD-exacerbation/Risk-Factors]
Female
Ref: Uptodate [ COPD exacerbations: Clinical manifestations and evaluatio]

Cause

 Ischemic heart disease
Note: Strong risk factor /also may be a cause
Ref: Uptodate [ COPD exacerbations: Clinical manifestations and evaluatio]
Myocardial ischemia
Note: Strong risk factor /also may be a cause
Ref: Uptodate [ COPD exacerbations: Clinical manifestations and evaluatio]
Swallowing dysfunction
Ref: Epocrates [ https://online.epocrates.com/diseases/832/Acute-COPD-exacerbation/Risk-Factors]

Other