Emphysema Case Study

Case Study

Finley Welton

Patient Information: Amy Sallow- 58 year old female- Lives in rural Arizona- Works in the livestock industry- Has been smoking for nearly 35 years

Patient History and symptoms

- As a child, Amy had frequently missed school due to respiratory infections- Since she works in the livestock industry, she is constantly breathing in dust and chemicals from the surrounding desert land and animals- She has had a mucus producing cough for many years, and assumed it was a side effect of smoking- More recently, she had noticed breathing difficulty when trying to work with the animals- She had begun to often get respiratory infections again, similar to how she did when she was a child

Tests performed

• Checked weight
• Checked Blood Pressure
• Checked heartbeat
• Listened to lungs
• Pulse Oximetry
• Pulmonary Function Test

results

• Her blood pressure was a little higher than normal, but it was not concerning
• There were soft wheezing sounds in her lungs

• Her blood oxygen levels were realatively normal
• After her PFT, her results came back less than average

What do you believe Amy's diagnosis is?

The diagnosis

Due to her history of respiratory infections and common symptoms, Amy was diagnosed with Bronchitis

Treatment

Amy was prescribed a long-term corticosteroid bronchodilator inhaler to help fight her current respiratory infection and help to support her respiratory system against developing new ones

However, after a month on the inhaler, she had began to return back to her prior state and have worsening symptoms.

Patient History and symptoms

- As a child, Amy had frequently missed school due to respiratory infections such as pneumonia and bronchitis- Since she works in the livestock industry, she is constantly breathing in dust and chemicals from the surrounding desert land and animals- She has had a mucus producing cough for many years, and assumed it was a side effect of smoking- More recently, she had noticed breathing difficulty when trying to work with the animals- She had begun to often get respiratory infections again, similar to how she did when she was a childSince the last visit:- Her cough has intensified, and she now experiences coughing fits that last minutes- After her last visit, she had stopped smoking- Her shortness of breath has began to worsen, and now takes place when she is not only working with the animals and maintenance work, but also doing things such as playing with her grandkids and vacuuming the house- When she is not having a breathlessness sensation, her husband has began to notice wheezing

• Checked weight
• Checked Blood Pressure
• Checked heartbeat
• Listened to lungs
• Pulse Oximetry
• Pulmonary Function Test
• CT scan

Tests performed

results

• There was unexplained weight loss
• Her blood pressure increased
• There are wheezing and crackle sounds in her lungs
• She has a "barrel chest" now where her chest is fixed in an outward position
• Her blood oxygen levels are very low
• Since last time, her performance on the PFT had dropped even lower below the average
• In her CT scan, Amy's doctor was able to find masses of damaged lung and alveoli pockets

What do you believe Amy's second diagnosis is?

what do you think was the greatest factor in the development of her emphysema?

The second diagnosis

Because of the lowered breathing performance, smoking history, and areas of damaged alveoli, Amy was diagnosed with Emphysema

treatment

Since there is no immediate cure for emphysema, the doctors had aimed to ease her symptoms and slow the progression- They recommended her husband stop smoking so she didn't have secondhand smoke- She should reduce her work out in the dust- She should continue to go on walks and perform light physical activity- They prescribed her with a Glycopyrrolate/formoterol (Bevespi Aerosphere) inhaler

What is emphysema

07.How does it pathologically affect the body

01.Description

06.Prevention

05.treatment

04.diagnosis

03.Signs and symptoms

02.Etiology

description of emphysema

Emphysema is one of the disease that is part of the COPD disorder (chronic obstructive pulmonary disorder) and is a disease that progresses very slowly over time

When the alveoli burst, it reduced the lung surface area which traps the destroyed tissue and then prevents oxygen from getting to the bloodstream

Emphysema is where the alveoli get damaged and it causes them to burst whic creates a large sac in the lungs of air in the lungs instead of a bunch of small ones in the alveoli

The lungs then slowly overfill and causes breathing to become increasingly difficult

Etiology

One of the biggest known causes for Emphysema is smoking, but other causes could be constant inhallation of air pollutants (fumes, chemicals, dust, etc), respiratory infections, and a genetic Alpha-1 antitryspin deficiency.

prevention

The easiest way to prevent against Emphysema is to not smoke and to reduce the amount of extra molecules in things such as air pollutants.

Signs and symptoms

wheezing

weight loss

Shortness of breath

cyanosis

Coughing up mucus

fatigue

chest pain

edema

chest infections

Muscle weakness

Diagnosis

Laboratory Tests include:- Chest X-Rays- CT Scans- Pulse Oximetry- Spirometry- Pulmonary Function Tests- Arterial Blood Gas- Electrocardiogram

treatment

There is no cure for Emphysema, but there are plenty of treatment options that can help to lessen symptoms such as: bronchodilators, anti-inflammatory medicine, oxygen therapy, and if serious enough, a lung transplant.The whole goal of treatments are simply just to ease the symptoms and slow the progression of the disease

How does it pathologically affect the body?

Circulatory system

When the lungs begin to fill up with trapped air and expand in the rib cage, it causes external pressure on the heart and impairs it from pumping blood. Also, since the heart is a muscle, the lack of oxygen affects how well it is able to pump blood around the body.

Digestive system

When the lugns expand, it also pushes on the stomach and other abdominal organs which prevents the person from eating enough food because the stomach has less room to fill up. Also, with the lack of oxygen, it is possible for people to have trouble gaining nutrients from food.

immune system

Due to the nature of this disease, it can easily be associated with frequent respiratory infection which will decrease the strength of the immune system and weaken its ability to fight against other pathogens elsewhere in the body.

nervous system

Overall, the lack of oxygen in the body will most likely affect the nervous system. It can cause damaged or impaired brain function and result in things such as epilepsy, dimentia, parkinson's disease, sleep disorders, and strokes.

Sources

• https://www.lung.org/lung-health-diseases/lung-disease-lookup/emphysema#:~:text=Emphysema%20is%20one%20of%20the,alveoli%20(tiny%20air%20sacs).
• https://www.webmd.com/lung/copd/emphysema-diagnosis-and-treatments
• https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/symptoms-diagnosis/early-warning-signs
• https://www.thoracic.org/patients/patient-resources/resources/pulmonary-function-tests.pdf
• https://www.mayoclinic.org/diseases-conditions/emphysema/symptoms-causes/syc-20355555
• https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/emphysema#treatment-for-emphysema
• https://www.webmd.com/lung/copd/copd-bloating