Take a deep breath and tune in to this week’s episode full of COPD diagnosis and management pearls, with expert Dr. Denitza Blagev, a pulmonologist, intensivist, and Medical Director for Quality, Speciality Care at Intermountain Healthcare in Utah with a particular interest in physician wellness and issues related to women in medicine. We cover: history taking, interpreting PFTs, patient counseling, inhalers and medications, exacerbations, antibiotics, steroids, and who needs BIPAP...so basically everything you ever wanted to know about chronic obstructive pulmonary disease. Take our self assessment here. Sponsored by @nephmadness. Registration opens March 15th at AJKDblog.org Written and produced by: Leah Witt, MD, Cyrus Askin, MD. Edited by Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 NephMadness announcement 01:10 Disclaimer 01:45 Intro 03:50 Guest bio 05:03 One liner; What advice would you give our younger self?; Should I do a fellowship?; Book recommendations 10:30 Picks of the week 15:50 Case of COPD from Kashlak Memorial 16:55 Initial approach to a potential case of COPD 18:34 Misdiagnosis of COPD 20:10 Classic spirometry in COPD and GOLD 0 21:30 Diagnosis of emphysema 23:18 Diagnosis of chronic bronchitis 24:54 Counseling the patient with a new diagnosis of COPD 27:00 Spirometry 28:45 How to read PFTs 33:29 How to order PFTs and get what you want 36:00 Why does pre- and post-bronchodilator response matter? 38:45 Asthma COPD overlap syndrome 40:13 Staging of COPD, does it matter? 42:50 Prognosis in COPD 45:00 Therapies with mortality benefit 48:29 Therapies to improve symptoms and prevent exacerbations 52:00 Azithromycin as chronic therapy 53:00 Counseling patients on therapy 55:00 Short acting inhalers in COPD 56:20 Treatment of COPD exacerbations 59:18 Antibiotics, who needs them in exacerbation 61:52 Nebulized inhaled steroids 63:18 Duration of antibiotics and steroids during an exacerbation 66:30 Who needs BIPAP chronically? 69:22 Who needs BIPAP during an exacerbation? 71:33 How often should PFTs be repeated? 73:00 When should we suspect PE in COPD exacerbation? 74:25 Which labs should be check in the initial COPD workup? 76:46 Take home points Tags: copd, chronic, pulmonary, disease, asthma, emphysema, bronchitis, inhaler, nebulizer, steroids, embolism, exacerbation, bipap, cpap, antibiotics, azithromycin, doxycycline, mortality, oxygen, spirometry, dlco, fev1, fvc, pfts, #nephmadness, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student