Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive exertional dyspnea and a chronic, non-productive cough. History significant for [exposure/transplant/infection]. Symptoms are refractory to standard bronchodilator therapy. No reported orthopnea or paroxysmal nocturnal dyspnea.
Clinical Examination Findings
General: Patient appears in no acute distress at rest. Respiratory: Auscultation reveals diminished breath sounds, occasional end-expiratory wheezing, or silent chest. No signs of consolidation. Cardiovascular: Regular rate and rhythm, no murmurs, no peripheral edema. Skin: No cyanosis or clubbing noted.
Treatment Protocol
Initiate trial of high-dose inhaled corticosteroids and long-acting bronchodilators. Consider systemic immunosuppression (e.g., azathioprine, mycophenolate) if inflammatory component is suspected. Pulmonary rehabilitation referral. Monitor FEV1/FVC ratio via serial spirometry.