Assignment Task:
Ms. Smith, a 59-year-old female who works as an accountant, presents to the clinic with cough, shortness of breath, and increased sputum production. Her past medical history is significant for COPD with chronic bronchitis, hypertension, diabetes, hyperlipidemia, and GERD. She reports that her sputum has increased in consistency and amount over the past few days. Her last exacerbation was about 6 months ago, for which she received oral antibiotics. This is her third exacerbation in the past year. She has a 40-pack-year history of cigarette smoking and quit smoking 3 years ago. She does not take chronic steroids and is not adherent to her medical therapy. Physical exam reveals rhonchi and expiratory wheezes. Her vital signs are blood pressure 140/83 mm Hg, pulse rate 80 beats/min, respiration rate 20 breaths/min, temperature 37.9°C, and O2 saturation 92% nasal prongs 1 L/min. She has no known drug allergies. A sputum Gram stain in the office reveals purulent sputum (presence of WBCs). Chest x-ray findings are negative for pneumonia, and a COVID-19 test is pending. The physicians ordered droplet and contact isolation.
1. What is the relationship between Ms. Smith's COPD and cigarette smoking?
2. Why was Ms. Smith at higher risk of contracting COVID-19? Need Online Tutoring?
3. What are the potential pathophysiological conditions that can lead to increased oxygen demands or desaturation?
4. The physician ordered a short course of dexamethasone. Explain the rationale for starting this medication.