To update you on:
- The diagnosis of COPD, with reference to both the NICE and GOLD guidelines and the difference between them.
- Initial treatment of COPD.
- Escalation and de-escalation of COPD treatment.
- The management of COPD exacerbations.
- Palliative care in a patient with COPD.
- What to do if a patient with COPD requests a ‘fit to fly’ letter.
Dr Toni Hazell is a GP in North London
Case study 1 – Mr M
Mr M is a 68-year-old man who has come to see you with a cough. You notice that he has been seen six times in the last year with a few weeks history of productive cough – each time he has had antibiotics. You decide to take a more detailed history, which reveals that his cough isn’t really getting better in between each course of antibiotics. Mr M is retired from his job as an accountant and had hoped that his retirement would be a time when he could play more golf, something that he always enjoyed but never had the time for. He has been disappointed to find that he can’t really walk around the course without getting short of breath and sometimes wheezing and finds that he is getting fewer invitations to play than he used to.
You wonder if he has COPD and decide to gather some more information. What else you might ask in the history?
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