Core IM | Internal Medicine Podcast

#107 COPD: 5 Pearls Segment

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Jun 22, 2022
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ADVICE

Confirm COPD Diagnosis

  • Always confirm COPD diagnosis with spirometry, even if the patient has respiratory symptoms and a smoking history.
  • About 33% of patients are misdiagnosed with COPD without spirometry.
INSIGHT

Bloodwork for COPD

  • Check all COPD patients for alpha-1 antitrypsin deficiency once and for eosinophil levels (when not on steroids).
  • Eosinophil counts guide inhaled corticosteroid (ICS) use; higher counts suggest an inflammatory phenotype.
ADVICE

Initial COPD Treatment

  • Start COPD treatment with a long-acting muscarinic antagonist (LAMA) for most patients (Groups A, B, and C).
  • For Group D (high symptom burden), use LAMA/LABA or LAMA/ICS based on eosinophil levels.
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