Week 2: COPD Case Study Part 1

(Initial post due Tuesday, faculty and

peer responses due Sunday)

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Purpose

Problem-based learning is a methodology designed to help students develop the reasoning process used in

clinical practice through problem solving actual patient problems in the same manner as they occur in

practice. The purpose of this activity is to develop students’ clinical reasoning skills using a case-based

learning exercise. Through participation in an online discussion forum, students identify learning issues in a

self-directed manner which facilitates learning for the entire group.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

1. Demonstrate competence in the evaluation and management of common respiratory

problems (WO 2.1) (CO,2,3,4,5)

2. Distinguish between obstructive and restrictive lung disease (CO 2, 4) Develop a management

plan for the case study patient based on identified primary, secondary and differential diagnoses. (WO 2.2)

(CO 2,4)

3. Interpret pulmonary function test results. (WO 2.3) (CO 2, 4)

Due Date:

Student enters initial post to part one by 11:59 p.m. MT on Tuesday; responds substantively to at least one

topic-related post of a peer including evidence from appropriate sources AND all direct faculty questions in

parts one by Sunday, 11:59 p.m. MT.

A 10% late penalty will be imposed for discussions posted after the deadline on Tuesday 11:59pm MT,

regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e.

student will receive an automatic 0).

Total Points Possible: 50

Case Study - Part 1

Date of visit: November 20,2019

A 62 year-old Caucasian male presents to the office with persistent cough and recent onset of shortness of

breath. Upon further questioning you discover the following subjective information regarding the chief

complaint.

History of Present Illness

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Onset 6 months

Location Chest

Duration Cough is intermittent but frequent, worse in the AM

Characteristics Productive; whitish-yellow phlegm

Aggravating

factors Activity

Relieving factors Rest

Treatments

Tried Robitussin DM without relief of symptoms

Severity Unable to walk > 20ft without stopping to catch his breath. Last year at this time he routinely walked 1 mper day without difficulty

Review of Systems (ROS)

Constitutional Denies fever, chills, or weight loss

Ears Denies otalgia and otorrhea

Nose Denies rhinorrhea, nasal congestion, sneezing or post nasal drip.

Throat Denies ST and redness

Neck Denies lymph node tenderness or swelling

Chest Describes a persistent productive cough upon wakening for the last 6 months. Color of phlegm is usuallywhite-yellowish. Shortness of breath with activity.

Cardiovascular Denies chest pain and lower extremity edema