History and physical examination for COPD

Exam Overview

Your medical history provides important clues that can help your doctor diagnose chronic obstructive pulmonary disease (COPD).

In taking your medical history, your doctor will ask questions about:

• Shortness of breath.
  • When were you first short of breath (at exercise or at rest)?
  • How often are you short of breath?
  • How long have you been short of breath? Is it getting worse?
  • How far can you walk and how many steps can you climb before having to stop because of shortness of breath?
• Coughing.
  • How often and when do you cough?
  • How long have you been coughing? Is it getting worse?
  • Do you cough up mucus (sputum)? What color is it?
  • Have you ever coughed up blood?
• Your and your spouse's or housemate's use of tobacco: whether any of you smoke, how long you've smoked, how many cigarettes a day you smoke, how long ago you quit smoking, whether you feel you can quit smoking, and more.
• Exposure to airborne irritants, such as dust or chemicals, on the job.
• Childhood respiratory illnesses.
• Family history of respiratory disease.
• Other medical conditions you may have and their treatment.
• How your condition is affecting your quality of life: missed work, disrupted routines, and depression, for example.
• The name and dose of all of the medicines you take, including any inhalers you use.
• What type of family and social support you have.

During the physical examination, your doctor will examine your body for other clues that may explain the cause of your symptoms. A physical exam involves:

• Taking your temperature, weight, and body mass index (BMI), which measures weight for height and provides a way to estimate the effect of weight on health.
• Examining your ears, eyes, nose, and throat for signs of infection.
• Listening to your heart and lungs with a stethoscope.
• Checking for signs that blood is backing up in your neck veins, which may point to a heart problem such as cor pulmonale.
• Pressing or tapping on your abdomen (abdominal palpation).
• Examining your fingers and lips to see whether the skin has a blue tint (cyanosis).
• Checking your fingers to see if their ends swell and the nails bulge outward (clubbing).
• Evaluating your legs and feet for swelling (edema).

A physical examination is not painful, but parts of it (such as abdominal palpation) may feel slightly uncomfortable.

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