PULMONOLOGY
Etiology
• Cigarette smoking (most common)
• Environmental pollutants
• α₁-antitrypsin deficiency (genetic)
Pathogenesis
• Chronic inflammation → airway remodeling + alveolar destruction → airflow limitation
Clinical features
• Chronic cough with sputum
• Dyspnea on exertion, progressive
• Barrel chest, use of accessory muscles
Lab findings
• PFTs: ↓ FEV₁, ↓ FEV₁/FVC ratio (<0.7)
• Hypercapnia, hypoxemia in advanced disease
• CXR: hyperinflated lungs, flattened diaphragm
Treatment
• Smoking cessation
• Bronchodilators (SABA, LABA, anticholinergics)
• Oxygen therapy in severe hypoxemia
• Pulmonary rehab, steroids during exacerbations