CPC PROTOCOL

Problem Lists

• Difficulty of breathing

• Cough with whitish phlegm

• Easy fatigability

• Throat discomfort

• Productive cough of yellowish phlegm

• Weight loss

• Bidpedal edema

• Chest discomfort

• cyanosis

Problem Lists

• Cardiopulmonary distress

• Tachycardic

• Tachypnic

• Wheezing

• Crackles

• Murmur

• Hepatomegaly

• Clubbing

• Respiratory acidosis

Problem Lists

• Erythrocytosis

• Hyponatremic

• Hyperkalemic

• Increase creatinine

• Increase BUN

• Pulmonary congestion

• AV dissociation

• Cardiomegaly

• Hypoxemia

BRONCHIAL ASTHMA

COPD

TUBERCULOSIS

VSD

CHF

HISTORY OF PRESENT ILLNESS

•Difficulty of Breathing•History of PTB at 12yo and was treated for 6 months•Cough with whitish phlegm•Easy fatigability•Throat discomfort•Productive cough of yellowish phlegm•Weight loss•Bipedal edema•Chest discomfort•Slight relief after administration of a bronchodilator (Salbutamol)•Cyanosis

Rule In• Difficulty of breathing• productive cough• chest discomfort• slight relief after

administration of a bronchodilator (Salbutamol)

• Wheezing

PHYSICAL EXAM•Cardiopulmonary distress•Tachycardic•Tachypnic•Wheezing•Crackles•Murmur•Hepatomegaly•Clubbing•Respiratory acidosis

LABORATORY•Erythrocytosis•Hyponatremic•Hyperkalemic•Increase Creatinine•Increase BUN•Pulmonary Congestion•AV Dissociation•Cardiomegaly•Hypoxemia

Rule In

• Difficulty of breathing

• productive cough

• chest discomfort

• slight relief after administration of a bronchodilator (Salbutamol

• Wheezing

• )

2014 GINA (GLOBIAL INITIATIVE FOR ASTHMA)

2014 GINA (GLOBIAL INITIATIVE FOR ASTHMA)

2012 GINA POCKET GUIDE FOR ASTHMA MANAGEMENT AND

PREVENTION

2012 GINA POCKET GUIDE FOR ASTHMA MANAGEMENT AND

PREVENTION

Symptoms respond to anti-asthma therapy

FISHMAN’S PULMONARY DISEASES AND DISORDERS, fourth edition

FISHMAN’S PULMONARY DISEASES AND DISORDERS, fourth edition

Bronchial Asthma

Rule Out•No family history of asthma or atopic diseases•No symptoms occur or worsen in a seasonal pattern•No symptoms occur or worsen at night or in the early morning•No confirmatory lung function test done (spirometry)•No signs of hyperinflation and diminished breath & heart sounds

2012 GINA POCKET GUIDE FOR ASTHMA MANAGEMENT AND

PREVENTION

2012 GINA POCKET GUIDE FOR ASTHMA MANAGEMENT AND

PREVENTION

FISHMAN’S PULMONARY DISEASES AND DISORDERS, fourth edition

FISHMAN’S PULMONARY DISEASES AND DISORDERS, fourth edition

BRONCHIAL ASTHMA

COPD

TUBERCULOSIS

VSD

CHF

Rule In• Difficulty of Breathing• History of PTB at 12yo and

was treated for 6 months• Easy Fatigability• Productive cough with

yellowish phlegm• Weight loss

HISTORY OF PRESENT ILLNESS

•Difficulty of Breathing•History of PTB at 12yo and was treated for 6 months•Cough with whitish phlegm•Easy fatigability•Throat discomfort•Productive cough of yellowish phlegm•Weight loss•Bipedal edema•Chest discomfort•Slight relief after administration of a bronchodilator (Salbutamol)•Cyanosis

PHYSICAL EXAM•Cardiopulmonary distress•Tachycardic•Tachypnic•Wheezing•Crackles•Murmur•Hepatomegaly•Clubbing•Respiratory acidosis

LABORATORY•Erythrocytosis•Hyponatremic•Hyperkalemic•Increase Creatinine•Increase BUN•Pulmonary Congestion•AV Dissociation•Cardiomegaly•Hypoxemia

Pulmonary Tuberculosis

Rule In• Difficulty of Breathing• History of PTB at 12yo

and was treated for 6 months

• Easy Fatigability• Productive cough with

yellowish phlegm• Weight loss

Pulmonary Tuberculosis

Rule Out• (-) Fever• (-) Hemoptysis• (-) Night Sweats• (-) Pleuritic chest pain• Chest Xray result: no

infiltrates or cavitation in the apical and posterior segments of the upper lobes