Patients with undiagnosed chronic obstructive pulmonary disease (COPD) can sometimes hide in plain sight.
1 Sep 2022
Inhaled bronchodilators may not improve respiratory symptoms in tobacco-smoking patients with preserved lung function
A randomized controlled trial in patients with at least a 10 pack-year smoking history and respiratory symptoms but normal spirometry results found no difference in symptoms over 12 weeks between those who received indacaterol plus glycopyrrolate twice daily or placebo.
13 Sep 2022
A 40-year-old man is evaluated 10 days after an ED visit for a cough, chest tightness, wheezing, and shortness of breath. He reports a similar episode requiring an ED visit one year ago. Following a physical exam and cardiopulmonary exam, what is the most appropriate management?
29 Mar 2022
ACP is launching a new campaign to educate about the depth and diversity of internal medicine and highlight the value that all internal medicine physicians bring to health care.
1 Sep 2022
A 35-year-old woman is evaluated for a 4-month history of exertional dyspnea and a 1-week history of chest pressure. She has no sputum production, cough, or wheezes. She has never smoked. Following a physical examination, laboratory studies, electrocardiogram, and chest radiograph, what is the most appropriate initial test?
17 Mar 2020
Pulmonary arterial hypertension can be recognized and treated. But it remains a diagnosis that is often missed, and the delay can lead to a rapidly progressing and fatal outcome. Learn the signs beyond a patient who reports “being out of breath.”.
1 Apr 2013
A 52-year-old man is evaluated in follow-up after being diagnosed with severe obstructive sleep apnea 8 weeks ago. Continuous positive airway pressure (CPAP) was prescribed based on a titration during in-laboratory polysomnography. He notes some improvement in his sleep with CPAP, but he still feels drowsy during the day. Following a physical exam, cardiopulmonary exam, and neurologic exam, what is the most appropriate next step in management to address this patient's continued drowsiness?
5 Jun 2018
Early detection of pulmonary embolism is critical, which puts the primary care internist on the front lines of preventing a patient's continual deterioration that culminates in death. Patients are as likely to present in the office with symptoms as they are at the emergency department.
1 Mar 2013
Because not all presentations of lung diseases include gastroesophageal reflux disease (GERD)'s more commonly recognized symptoms, such as heartburn and regurgitation, it is easy to miss GERD as a contributing factor. Internists should be on the lookout for “red flags” such as dysphagia or weight loss.
1 Mar 2014
A 45-year-old man is evaluated for a 6-month history of increasing daily cough, sputum production, and dyspnea on exertion. He has been employed as a coal miner for 10 years. He has never smoked and does not have a history of diabetes mellitus, hypertension, or hyperlipidemia. Pulmonary examination reveals mildly decreased breath sounds bilaterally with no wheezes, crackles, or rhonchi. Cardiac examination and chest radiograph are normal. What is the most appropriate next step in management?
17 Sep 2013