Question Answered step-by-step Global Initiative for Obstructive Lung Disease (GOLD) Criteria for COPDAssesses different stages of COPD and provides treatment recommendations.INSTRUCTIONSUse in patients >18 years of age with already-diagnosed COPD by spirometry (FEV1/FVC <0.7) with baseline symptoms and lung function. Do not use to diagnose COPD and do not use in patients with acute exacerbation.When to UsePearls/PitfallsWhy UseSymptom burdenmMRC 2 = Walks slower than people of the same age because of dyspnea or has to stop for breath when walking at own pace; CAT 10 = COPD symptoms have low-medium impact on patient's lifeLower (mMRC <2 or CAT Score <10)Higher (mMRC =2 or CAT Score =10)Exacerbation history0 exacerbations1 exacerbation without hospital admission=1 exacerbation with hospital admission=2 exacerbationsFEV1 % of predicted=8050-7930-49<30Result_Please fill out required fields.Next StepsEvidenceCreator InsightsDr. Edward PetsonkABOUT THE CREATOREdward Petsonk, MD, is a professor of medicine at West Virginia University. He is a practicing pulmonologist and critical care physician and has been published in the literature on occupational deficits due to lung disease. Dr. Petsonk is also a retired captain in the US Public Health Service.To view Dr. Edward Petsonk's publications, visit PubMedAre you Dr. Edward Petsonk? Send us a message to review your photo and bio, and find out how to submit Creator Insights!MDCalc loves calculator creators - researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.Student COPD Case StudyA 38-year-old female amateur astronomer, all the while knowing better, has smoked since she was 18 years old. She has been having trouble for years with the smoke and the light of the cigarette impairing her ability to see the more distant galaxies through her telescope, but she has not been willing to quit yet.Additionally, she has noticed a mild, occasionally productive cough for the past 3-4 months. The cough is worse whenever she spends the night out in the country taking astrophotos where she is exposed to the smoke of the nearby wildfires.She finally decides to visit her family physician who, after making appropriate patient-centered inquiries as to how her astrophotography hobby is going, finds that she has been smoking about one pack per day for the past 20 years. The cough has been present for almost a year. She has had no fever or chills. She does admit to more shortness of breath when she exercises over the past six months, at times she has to stop walking as due the shortness of breath.Her only other past medical history includes hypertension for which she is using lisinopril, metoprolol, and hydrochlorothiazide.At this point, what further investigations do you think would be appropriate?A. Chest radiograph (CXR)B. Computed axial tomography (CT) of the chest.C. Complete blood count (CBC) and thyroid stimulating hormone (TSH) levelD. SpirometryE. A and DYou perform a physical exam and obtain a CXR in the office; the findings are normal. You had the foresight to obtain a spirometry machine for your family medicine clinic, and the post-bronchodilator study demonstrates the following:- FEV1: 85% of predicted.- FEV1/FVC: 65%How would you interpret these findings in light of her clinical picture?A. NormalB. Moderate COPDC. Restrictive lung diseaseD. Mild COPDE. Mild Asthma Health Science Science Nursing NURE 231 Share QuestionEmailCopy link Comments (0)
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