Week 2 COPD Case Study Part 1

Week 2: COPD Case Study Part 1

Week 2: COPD Case Study Part 1 (Initial post due Tuesday, faculty and peer responses due Sunday)

PurposeProblem-based learning (PBL) is a teaching methodology aimed at developing students' clinical reasoning skills by solving real patient problems in the same manner they would be encountered in practice. The purpose of this activity is to enhance students' clinical reasoning abilities using a case-based learning exercise. Through participation in an online discussion forum, students will identify learning issues in a self-directed manner, which helps facilitate learning for the entire group.

Activity Learning OutcomesThrough this discussion, the student will demonstrate the ability to:

Competence in Evaluation and Management: Demonstrate competence in the evaluation and management of common respiratory problems. (WO 2.1) (CO 2, 3, 4, 5)
Differentiation of Lung Diseases: Distinguish between obstructive and restrictive lung diseases. (CO 2, 4)
Development of Management Plan: Develop a management plan for the case study patient based on identified primary, secondary, and differential diagnoses. (WO 2.2) (CO 2, 4)
Interpretation of Pulmonary Function Tests: Interpret pulmonary function test results. (WO 2.3) (CO 2, 4)

Due Date:

Initial Post: The student must enter the initial post to Part 1 by 11:59 p.m. MT on Tuesday.
Responses: The student must respond substantively to at least one topic-related post of a peer, including evidence from appropriate sources, and respond to all direct faculty questions in Part 1 by Sunday, 11:59 p.m. MT.
Late Penalty: A 10% late penalty will be imposed for discussions posted after the Tuesday 11:59 p.m. MT deadline, regardless of the number of days late. NOTHING will be accepted after 11:59 p.m. MT on Sunday (i.e., the student will receive an automatic 0).

Total Points Possible: 50

Case Study - Part 1

Date of Visit: November 20, 2019

Patient Information:

Age/Gender/Race: 62-year-old Caucasian male
Chief Complaint: Persistent cough and recent onset of shortness of breath

History of Present Illness (HPI):

Onset: 6 months ago
Location: Chest
Duration: Cough is intermittent but frequent, worse in the morning
Characteristics: Productive cough with whitish-yellow phlegm
Aggravating Factors: Activity
Relieving Factors: Rest
Treatments Tried: Robitussin DM without relief of symptoms
Severity: Unable to walk more than 20 feet without stopping to catch his breath. Last year at this time, he routinely walked 1 mile per 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 sore throat and redness
Neck: Denies lymph node tenderness or swelling
Chest: Describes a persistent productive cough upon wakening for the last 6 months. The color of phlegm is usually white-yellowish. Shortness of breath with activity.
Cardiovascular: Denies chest pain and lower extremity edema

History:

Medications: Metoprolol succinate ER (Toprol-XL) 50 mg daily for hypertension; Multivitamin daily
PMH: Primary hypertension
PSH: Cholecystectomy, appendectomy
Allergies: Penicillin (hives)
Social History:
- Marital Status: Married, 3 children
- Occupation: Senior accountant at a risk management firm
- Habits: (To be detailed in further parts)

Instructions:Students should use the information provided to:

Identify and discuss the likely differential diagnoses for the patient’s symptoms.
Evaluate the patient’s current treatment regimen and suggest any necessary changes.
Propose a comprehensive management plan, including any additional diagnostic tests that may be necessary.
Discuss how the patient’s social and occupational history might influence the management and outcomes of the condition.
Respond to at least one peer’s post with evidence-based support and address any faculty questions posed during the discussion.