154
Clinical8516010126101140179258296358429467
Manifestations13536010126133202280319366428482529598645683753831886
of2273601012670117
COPD:24256010126102210296397443
1.671978012870106
Breathing851978012894140203265304374412483552
difficulty1439978012870108156202240303372412450521
(dyspnea):1993978012847117187240311381444505552591
o671132308060
Progressive8511287012878125195265312374428483521592654
(worsens15401287012846148217264318381450505
over20791287012871141204249
time),2364128701283977186246293328
o671156508060
Typically8511529012886156225264327389427467537
worsens142215290128101170217272335404459
during19151529012870141187226297366
physical23151529012870141212264304367429467
exertion,28171529012863132194241279318388458492
o671180608060
Persistent.8511770012878140187242280335374437506545581
2.6712011012870106
Chronic8512011012894164211280351389452
cough:13382011012862132202272341381
o671235608060
Can8512320012894156226
be11112320012870133
intermittent12792320012839109148210257366402442481544613653
and19672320012863131202
may220423200128110169241
be24782320012870132
unproductive;26462320012870141210257326397467529567607676739778
can34602320012861123193
be36872320012870133
accompanied38552320012863125186256366434497567605667737
by46282320012870140
recurrent48022320012847109171241289335396467505
wheezing.85125610128101171234296358396467537572
3.6712804012870106
Chronic8512804012894164211280351389452
sputum13382804012853124194233303412
production:17832804012870117187258328391430468538608647
o671314808060
Any85131120128101171242
chronic11263112012862132179249320359422
sputum15833112012854124193233302412
production20293112012870117187257326389427467536607
may267131120128110169241
indicate29453112012839109180218281342381444
COPD.34243112012894195272374408
Physical8513491012686163233289327390459498
Examination:13853491012693162233350387466535582621691768815
Inspection,8513729012847117172242305367405443514584619
palpation15053729012870132171240303341380450521
of20603729012870117
the22123729012839108171
chest,24183729012863131194248287323
percussion,27743729012870133180242311366420459528599635
and34443729012861130200
auscultation36803729012862132186249318357396458496536605675
of43943729012870118
the45473729012839108171
lungs47533729012838108178248302
to50913729012837108
identify8513970012839110172241280319367437
signs1321397001285594164234289
of16443970012870117
bronchial17963970012870117186256318388428489528
obstruction,23583970012871141195234281351413452490561631666
emphysema,30593970012862171240311382434497606666702
respiratory37963970012846108163234273320382420490537607
failure,44373970012847110149187258305366401
assess48733970012862117171234288342
the52513970012839108171
function8514210012847117188249289327397467
of13524210012870118
respiratory15054210012846109162233271318381419489535604
muscles,214542100128109177232294334396450485
and26654210012862132202
rule29034210012846116155217
out31544210012870140179
comorbid33694210012862131241309356426466535
conditions.39404210012862131201271310349387458528583618
Instrumental8514590012655133188235296374491552630677747786
Diagnostic167345900126101139209279357426481528566629
Investigations:23374590012653132202264318366404473544591629698777832878
671499709146
Measurement85149690128125187249304374421483592652723762
of16494969012870116
unprovoked18004969012870140210256325396466535598667
respiratory25034969012846109163233271318381420489537607
volumes31434969012870141180250360420474
and36534969012862132205
flows3894496901284684154255309
(spirometry)42394969012847101171209256327436496535582653698
to49734969012839109
detect51184969012870132171233296334
and8515210012862133202
assess10895210012862117170233287342
the14665210012838108171
severity16725210012853116185248295333372442
of21485210012870117
airway23005210012863102149250312382
obstruction.27165210012870140196234281350413451490560631666
If3417521001284693
initial35455210012838109147185225288326
signs3906521001285593162233287
of42295210012870117
bronchial43805210012870117187257320389427490529
obstruction8515452012870141195233281351412452490561630
are15175452012862109171
detected17225452012870133170233296333395465
(FEV1/FVC22235452012847125211311381419498599692
<0.7),29505452012880150185254301335
a33205452012862
bronchodilator34195452012869117187256319388459529567606669707777824
test42785452012839101155194
is4507545201283994
recommended46375452012846109171240350458517588658721791
to8515693012839110
determine9955693012870133170233280389426497559
the15895693012839109172
post-bronchodilator1796569301287013919323328235139846853860067073981084888894998810581105
value29355693012870133172242304
and32745693012861132201
the35115693012839108171
degree37175693012870132202249310373
of41255693012870117
reversibility42775693012849110180242289343382452491530569607678
of49885693012870117
obstruction8515935012870141195233281351412452490561630
under15155935012870141211273320
the18705935012838109171
influence20765935012838109156194263326395458520
of26315935012871117
bronchodilating27835935012870117186256318389458528567606668706746815885
drugs.37045935012870117186257311346
671620409146
Pulse8516176012878148188242305
oximetry11896176012870141180289349388435506
(oxygen17296176012846116187258326390460
saturation22256176012855116155225272334372412481551
in28116176012839109
blood29556176012870109179249318
SpO233086176012878148250320
<36636176012879
95%37766176012870140258
according40686176012863125187256303373411481551
to46556176012837108
pulse47976176012870140179233296
oximetry,8516419012870141179289349388435505539
to14266419012839109
detect15716419012870132170233295333
desaturation).19406419012870131185248287356404466504542613683730765