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#236 Approach to Shortness of Breath: Physical Exam Series

The Curbsiders Internal Medicine Podcast

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How to Diagnose a COPD Exacerbation With an Ultrasound

If you see A lines everywhere and they were already hyper-resonant when you're percussing, then you're pretty confident this is probably COPD. But again, the ultrasound in that case is probably confirming that which you already had a pretty good suspicion of prior to putting the probe on. The orthopnea, it turns out, is not incredibly helpful because many people with lung disease as well as heart disease can have orthopnea. So how do we absolutely nail this diagnosis with a physical examination? It's important to remember too that time is an important diagnostic tool - so your initial pretest probability is now modified.

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