47 - COPD Exacerbation Case Study

Question 1

What is a pneumothorax?

Answer 1

A pneumothorax is a collapsed lung which occurs when air leaks into the space between your lungs and chest wall. This air pushes on the outside of your lung and makes it collapse.

Question 2

What is a thoracentesis?

Answer 2

an invasive procedure to remove fluid or air from the pleural space

Question 3

At what size of a pneumothorax requires a thoracentesis?

Answer 3

25% or larger

Question 4

Would you be able to send someone with at 20% pneumothorax home?

Answer 4

No, they are still very sick and need to be monitored

Question 5

How do you diagnose COPD?

Answer 5

• Look at pulmonary function testing for COPD (values)

- If the patient has a FEV1/FVC that is less than 0.7, they can be definitively diagnosed with COPD

Question 6

What are the criteria for low dose CT screening for lung cancer?

Answer 6

• 55 to 74 years old
• In fairly good health
• Have at least a 30 pack-year smoking history
• Are either still smoking or have quit within the last 15 years)

Question 7

Describe the low dose CT screening process for lung cancer

Answer 7

• Patients who meet the criteria should get an annual low-dose chest CT
• This screening is recommended because if you find lung cancer early, it is very treatable, if you find it late, it is very lethal
• Medicaid/medicare will now pay for screening - cost effective