COPD Differential Diagnosis

Question 1

It can be difficult to diagnose between asthma and COPD clinically w/o post-bronchodilator spirometry - what 5 features from the Hx would make you consider asthma over COPD?

Answer 1

Diurnal variation
Nocturnal cough
FHx of atopies
Age

Question 2

What four clinical features would make you consider bronchiectasis over COPD?

Answer 2

COURSE crackles
Lots of childhood infections (serious)
Recurrent chest infections
Lots and lots of sputum production

Question 3

What four clinical features would make you consider heart failure over COPD?

Answer 3

Orthopnoea
PND
Basal crepitations (fine)
Risk factors for IHD

Question 4

What four clinical features would make you consider lung cancer over COPD?

Answer 4

Persistant/worsening cough
Heamoptysis
Systemic signs (malaise/weight loss)
Hoarse voice (RLN compression)

Question 5

Name four interstitial lung diseases and state two clinical features that would make you consider interstitial lung disease over COPD?

Answer 5

Dry cough

Fine lung crepitations