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2264 pages added, reviewed or updated during the last month (last updated: 21/4/2021)


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distinguishing asthma and COPD

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Distinguishing COPD form asthma is mostly carried out on the basis of patient history and examination. The following features should be used to differentiate the two conditions whenever possible (1):

  COPD Asthma
smoker or ex-smoker nearly all Possibly
symptoms under age of 35 rare often
chronic productive cough common uncommon
breathlessness persistent and progressive variable
night time waking with breathlessness and/or wheeze uncommon common
significant diurnal or day to day variability of symptoms uncommon common

 

In case of a diagnostic doubt the following can be done to differentiate between the two conditions:

  • serial domiciliary peak flow measurements
    • shows a 20% or greater diurnal or day-to-day variability
  • reversibility test using bronchodilators and corticosteroids can be used to separate asthma patients from those with COPD.
    • a large (> 400 ml) response to bronchodilators
    • a large (> 400 ml) response to 30 mg oral prednisolone daily for 2 weeks

Reference:

  • 1. National Institute for Health and Clinical Excellence (NICE) 2010. Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care.

Last reviewed 11/2019

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