Study the X- Ray provided
A) Describe the findings (3m)
B) What is your diagnosis (1m)
C) Describe the pathophysiology of B (4m)
D) Name two type of drugs to be given to this patients (2m)
Answer
A) 1) Increase AP diameter
2) Increase Retrosternal airspace
3) Flattened diaphragm.
B) COPD
C)
D) 1) Bronchodilator
- β- adrenergic agonist (Salbutamol 200µg every 6-6h)
- Antimuscarinic agents ( Tiotropium 18µg daily, ipratropium 40µg 4X daily, oxitropium 200 µg 2X daily)
- Long acting preparation of Theophyline
2) Corticosteroid
-Prednisolone 30 mg daily for 2w (measure lung function before and after treatment)
-Replace with inhaled beclometasone 400µg 2X daily when FEV1 > 15%
Nota tambahan (tak perlu mention kalau untuk exam purposes)
3) Antibiotic
-to prevent further lung damage.
-or as soon sputum turn yellow
- Cefaclor 500 mg 8-h daily, cefixime, 400mg once daily @ co-amoxiclav.
4) Diuretic therapy
- If Pt present with edema
5) α1 – Antitrypsin therapy
- when it serum level compound below 310 mg/L and abnormal lung function.
6) Vaccines
-yearly influenza vaccines
Sign and symptoms of emphysema
-Pink puffer
-Dyspnoea
-Barrel chest
-prolong expiration, sitting forward in hunched-over position.
-Hyperventilation
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