List and define each of the underlined words in the scenario. Tell what the abbreviations stand for and then describe what they mean. explain to the patient in normal terms what the doctor understood the problem to be

February 9, 2024February 9, 2024 Discipline: Biology

S: CC: 68 y/o male presents complaining of SOB.

                HPI: Pt states that he has suffered consistent dyspnea x4 days. States that the issue is worse with exertion and alleviated by leaning forward with arms across his chest. He has noted associated faintness and one episode of syncope yesterday. Syncope was witnessed, pt recovered immediately, no head trauma.
                PMHx: HTN x12 yrs, CHF x5 yrs, hypercholesterolemia x 7 yrs, MI 2017, NIDDM 2018
                PSHx: CABG (x4) 2017
                FHx: Lung CA, mother 1996
                Meds: Metoprolol (200mg/day), Atorvastatin (40mg/day), Metformin (1000mg/day)
                Social: Lives at home alone; Smoker (90 pack-years); ETOH 2-3 liquor drinks daily.
O: VS: BP: 138/91 T: 36.8 HR: 96 RR: 28
                PE: General: Pt is barrel chested and in distress, lips are pursed and he is supporting himself leaning over on the exam table.
Chest: hyperresonance on percussion, prolonged expiration, audible expiratory wheezes, no crackles in the base.
HEENT: notable JVPs
Heart: muffled heart sounds
ROS normal unless otherwise noted
                Radiology: Chest X-ray and CT show hyper-expansion of the lungs consistent with COPD
                Spirometry: Decreased FEV consistent with emphysema
A: 1. Emphysema
                2. Smoker, 2ppd
                3. CHF
                4. HTN
P: Tx plan as follows: Albuterol 10mg/hr continuous nebulizer used to treat acute symptoms. Rx for albuterol 5mg nebulized TID PRN, NTE 10mg/day and at-home supplemental oxygen 1-2L/min via nasal cannula given. Smoking cessation information given to patient with education on the importance of quitting smoking with emphysema. Pt to f/u with pulmonology next week for long-term care plan.

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