An 86-year-old man has had shortness of breath and a cough for the past two days. He is bringing up green sputum. He has a history of COPD. He uses an inhaler. During his exam, he is thin and short of breath at rest. Lung examination reveals poor air entry bilaterally. Heart and abdominal examination are normal. He lives with his daughter and she helps him with his daily activities. He is just about able to manage with her help. Even when well, he is only able to walk a few yards.
?
?
?
What would you advise to ensure quality patient care?
What is likely to be happening?
What tests should be run?
Visit the BMJ Best Practice website to find the answers to these questions: bit.ly/bp-scenario8
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bestpractice.bmj.com
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