Just Regular Chronic Obstructive Pulmonary Disease? If the History Doesn't Quite Match, Rethink Your Diagnosis
| Autor: | Timothy R. Wysozan, Michelle K. Zimmerman, Nicole Hubbard |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pediatrics
medicine.medical_specialty COPD Productive Cough Lung business.industry Inhaler Second opinion Disease Management General Medicine Middle Aged Hepatitis B medicine.disease Diagnosis Differential Pulmonary Disease Chronic Obstructive Pneumonia medicine.anatomical_structure medicine Humans Bronchitis Female Medical History Taking business |
| Zdroj: | The Journal of Applied Laboratory Medicine. 4:460-463 |
| ISSN: | 2475-7241 |
| DOI: | 10.1373/jalm.2018.028811 |
| Popis: | A 55-year-old woman presented to her primary care practitioner complaining of feeling as though she was frequently out of breath. She also complained of an approximately 20-year history of a productive cough every morning. The patient was a retired teacher, a nonsmoker, a social drinker, and taking no medications. Several months previously, she had an episode of bronchitis complicated by pneumonia that resolved after antibiotic treatment. However, since that time, her energy level had been low. She stated that she felt like she was breathing as though she were out of shape. Her primary care practitioner diagnosed her with chronic obstructive pulmonary disease (COPD)3 and prescribed β-agonist and steroid inhalers. She returned to her primary care practitioner 3 months later stating that she stopped using the inhalers because they did not work. Her primary care practitioner maintained the diagnosis of COPD and encouraged consistent inhaler use. Subsequently, she went for a second opinion. Radiographic studies showed bilateral emphysematous changes in the lower lung bases. Her liver enzymes were mildly increased. Hepatitis B and C serologies were negative. Among the other tests that were ordered was a serum protein electrophoresis (SPEP) study (Fig. 1). Fig. 1. SPEP study. (A), Patient's serum. … |
| Databáze: | OpenAIRE |
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