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Pathology Education Instructional Resource β

IPLab:Lab 12:COPD

Contents

Clinical SummaryEdit

This 64-year-old man was hospitalized because of increasing shortness of breath, cough, increasing sputum production, and fever. The patient had a 75 pack-year history of cigarette smoking. On admission his respiratory rate was 20 breaths per minute and his pulse was 110 bpm. On room air his PaO2 was 46 mm Hg, his PaCO2 was 62 mm Hg , and the pH was 7.26. Chest x-ray showed a low, flattened diaphragm, and markedly lucent regions in the upper lung fields suggesting areas of emphysema. Despite appropriate therapy he suffered acute respiratory failure and could not be resuscitated.

Pertinent autopsy findings included emphysema with moderate mucous plugging of bronchi. Right ventricular hypertrophy and dilation were also noted.

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Study QuestionsEdit


Additional ResourcesEdit

Related IPLab CasesEdit

Shortness of breath is a common clinical manifestation of heart failure.

A pack-year denotes smoking one pack of cigarettes per day for one year.

A normal respiratory rate is 10 to 20 breaths per minute.

A normal pulse rate is 60 to 100 bpm.

A normal PaO2 is 80 to 105 mm Hg.

A normal PaCO2 is 35 to 45 mmHg.

A normal arterial pH is 7.35 to 7.45.

Pulmonary emphysema is a condition in which the air spaces distal to the terminal bronchioles are permanently increased in size due to either destruction of the wall or alveolar dilatation.

Consolidation is the filling of lung air spaces with exudate--this is a sign of pneumonia.

In alcoholics, aspiration pneumonia is common--bacteria enter the lung via aspiration of gastric contents.