Discussion:
The Pink Buffer
Arnold, 67, visited his doctor for the first time in about ten years because he had noticed an increasing shortness of breath during gentle exercise. He has found this shortness of breath most noticeable whilst climbing stairs or walking up hills. Arnold had smoked one packet of cigarettes per day for about 50 years, but he recently gave up smoking because of his shortness of breath.
Arnolds doctor firstly noted that Arnold seemed thin and had a good skin colouration. On questioning it seemed that Arnold had developed a chronic cough that produced only a relatively small amount of sputum. However, he apparently suffered no chest pains, no wheezing or any noticeable changes in normal breathing. On examination, Arnold showed no cyanosis, but some edema of the extremities. He had a pulse of 110, a respiration rate of 18 (unlaboured), and a blood pressure of 115/86 and an oral temperature of 37 degrees C. Examination of Arnolds chest revealed hyper resonation and decreased breath sounds without wheezing or crackles. Pulmonary function tests revealed:
|
|
Measured
|
% predicted
|
|
FEV1
|
1.34 litres
|
45%
|
|
FVC
|
3.11 litres
|
88%
|
|
FEV1/FVC
|
43%
|
52%
|
1. After further laboratory tests Arnold was diagnosed as suffering from Emphysema.
2. Overview Arnold's history and answer the following questions:
3. Explain how Arnold's history as a smoker may have influenced progression of his disease.