255
Training851602012694156226265343382461530
Algorithmic14166020126101140209279342381427505622659722
Task:2173602012694164218297341
Clinical25506020126101139179257296359428466
Follow-up3052602012686155195233303403453531609
of3695602012671118
a3847602012670
COPD39526020126102210296397
Patient.4383602012686155202241303381428463
At8519390128101140
a1026939012863
therapist's1124939012838109171217280349388442482508561
appointment,1720939012863132202272310380419529589659699734
patient2489939012870133171209272341381
Andrey29059390128101171240288350419
Ivanovich3359939012846116179249319389428491560
Gurov39549390128102171218287357
(date4347939012846116178217280
of4660939012871118
birth:4813939012870108156195264303
09/21/1964)8511180012870141179249320358429498568639685
presents15711180012870117179233296365403458
with206311800128102140180249
complaints23481180012862132242310349412450520559614
of29961180012870117
a31481180012863
morning324411800128109177224295334405474
cough,37541180012862132202271342378
shortness41671180012852123193240278347410465519
of47201180012870117
breath48721180012871117179241280350
on52561180012870141
physical8511422012870141211264304366428467
exertion,13531422012863131194241279318388457493
and18811422012862132202
reduced21181422012847109178249312373443
exercise25971422012862131193240301340395457
tolerance.30891422012839109147209256318388451512548
He85117630128101163
has10491763012870133188
been12711763012870133195264
bothered15711763012870139178248311357419489
by20951763012870140
a22691763012862
smoker's23661763012854165233304366413438493
cough28951763012862131201271341
in32711763012838108
the34151763012837108170
mornings362017630128109176224294333404474528
for41831763012847117164
over43811763012870140203249
1046641763012870141
years48401763012871131193240294
and51701763012862131202
has8512004012870133188
had10732004012870133202
complaints13102004012863131241309348411450521559613
of19592004012870117
varying21102004012870133179249287358428
degrees25722004012871133202250312374428
of30352004012871116
shortness31872004012854124194241279349412465520
of37412004012870118
breath38942004012870117178240279349
for42792004012846115162
about44752004012863133203273311
448222004012870
years.49272004012870131193240295330
It5292200401284786
was85122470128101163218
initially11042247012839109148187226288327365436
intermittent,15732247012839109149212259368405444483545615655691
occurring22972247012870133195264311358396467536
only28672247012870141180250
during31502247012873144191230300369
significant3555224701285593163233271318357419482552590
physical41792247012871141212265304367429467
activity,46822247012862124163201271311349420453
but51692247012871141181
has8512488012870133188
become10732488012870133195264374434
persistent15422488012870132179234272327366429498536
over21142488012870139202249
the23982488012838108171
last26042488012838100154193
1-228312488012871120191
years.30572488012870131193240294330
He342224880128101163
experiences36202488012862132202264311349412481544606660
exacerbations43152488012862133194256319365436498537575646715769
once51202488012870139202265
a54202488012862
year8512729012870131193240
and11262729012862132203
is1365272901283992
treated1493272901283986148209248311380
on19072729012870141
an20832729012862132
outpatient22502729012870140180249312350389451521560
basis.28452729012870132187225280316
He319427290128101163
has33922729012870133188
not36142729012870140179
taken38282729012839101171234303
medications416627290128110169240279342404442482551621676
regularly.48772729012847109178248287350396435505539
CAT8512970012894195280
score11662970012854117187235297
is1498297001283893
12.16252970012870140176
mMRC183529700128110232326419
–22902970012870
2.23962970012870105
Height:253629700128101163201272341381419
17629892970012870141211
cm,32352970012861171204
weight:347429700128101163202272344383422
7739302970012871141
kg.41052970012870141176
BMI43162970012894217264
=46152970012879
24.947292970012870140175245
kg/m².50082970012870141179289329364
Waist85132120128133193232287327
Circumference12133212012894133179241311421465528574637707770831
=20783212012879
7621923212012870141
cm.23683212012863172204
He85135540128101163
has10493554012870133188
been12713554012870133195264
smoking15713554012854163231302342411481
for20863554012847117164
3222853554012870140
years,24613554012870130192239294329
half28253554012870133171218
a30783554012862
pack31753554012870132194265
of34743554012870117
cigarettes36263554012862102171234280342381419482535
per41973554012870132179
day,44103554012870133203237
and46823554012862132203
continues49203554012862133202240280350419482537
to8513795012839110
smoke.9963795012853163231301364399
There14303795012886155218265327
is1792379501283993
no19193795012870141
history20943795012871110164203273320390
of25183795012870117
occupational26703795012870133195265334397436474544615676716
hazards.34213795012870132194256303372427463
Pack-Year39183795012879141202272323424486547594
Index45463795012846117187249319
=49003795012880
16.50133795012871141177
Objective85141370128101171210272335374412483545
Data.143241370128101162200263298
On176641370128101171
examination,19724137012863131194303340411473512551621691727
the27344137012838108171
patient's29384137012870133174212275344383409462
condition34364137012862131202271311349388458528
is4000413701283992
satisfactory.41284137012854116155193248295357419458528575645678
Respiratory48414137012894156211281321367429468538585655
rate8514378012847109148211
is1097437801283893
1612244378012870141
per13994378012870133179
minute.161343780128110146217287326388424
The20704378012886155218
chest23234378012863133194249287
is2646437801283993
of27744378012870117
emphysematous29264378012862172239310380433495606666705775846901
shape,38624378012854123186256318353
percussion42504378012870132179240311366420458529599
note48844378012870140178241
is5160437801283993
hyperresonant8514619012870141209272319365428482553622685754793
(boxy),16804619012846115186255326371406
breathing21214619012870117179242281350389460529
is2686461901283992
harsh,28124619012871133180234304340
with318546190128101140179249
scattered34694619012855117180218256319366428497
sonorous40024619012855124193264311380450505
rhonchi45434619012846115185255318387426
bilaterally.8514862012870110148211249312358421459498569602
Heart148848620128101163225272311
sounds18354862012854123194264334388
are22594862012862109171
muffled,246548620128109177224271310373442477
rhythm29774862012847117188225294404
is3414486201283994
regular.35434862012847109180250289351398436
Heart401448620128101163225272310
rate43604862012846107146209
–46034862012870
8247094862012870139
bpm.48844862012870139249282
The52014862012886156219
abdomen8515103012862133202273382442513
is1399510301283994
soft;15295103012853123170209247
the18125103012839108171
liver2018510301283977148210256
is2309510301283993
palpable24375103012871133171241304374412475
at29475103012862100
the30835103012839108171
costal32885103012862132187226288326
margin,365051030128109169215286325396431
firm,4116510301284786132241274
and44265103012863133202
non-tender.46645103012870140210261300362431501564611646
There8515344012886155218265327
is1213534401283993
no13425344012870139
peripheral15155344012871133180218289358421468530568
edema21195344012862132194303363
in25175344012839109
the26625344012839109172
lower28705344012837108210271317
extremities.32225344012862133172218281390426466505568622657
SpO2=96%.39145344012878148250319398468538655690
Data85156910126101171218288
from11755691012647109178295
previously15045691012678140202273312382460514553623
performed21625691012678141203250318381498559637
additional28345691012670148226265312351420498568608
instrumental34775691012638116171217279357474535613660730769
studies:42825691012653100178255294357410457
Chest8516027012894164227280320
X-ray:120660270128101148195257327364
prominent16066027012870117186296333404466536575
pulmonary22156027012870141179289357427490537607
markings.285660270128109169216286326397466521557
Spirometry:8516409012878148188234304414474513560630668
FEV115546409012878164264334
–19246409012870
57%,20306409012870140258292
FEV1/FVC23576409012878164264334373451552645
=30386409012879
64%.31516409012870140257292
CAT34776409012894195281
=37926409012879
1339066409012870141
points.40826409012871140178249287341376
mMRC449464090128109231325418
=49486409012879
250616409012870
points.8516650012870141179249288342378