What are the conditions for diagnosing COPD? ( symptoms, risk factors, spirometry)
Global Initiative for Chronic Obstructive Lung Disease – GOLD
chapter 2: diagnosis and initial assessment
Global Initiative for Asthma

Does this patient have an acute exacerbation of COPD?
Global Initiative for Chronic Obstructive Lung Disease – GOLD
Chapter 5: management of exacerbations

What is the tests ordered in rule out the diagnosis of pulmonary tuberculosis?
結核病診治指引(第六版) - 衛生福利部疾病管制署
第三章 結核病的診斷

What are the next steps in management of this patient? 
Global Initiative for Chronic Obstructive Lung Disease – GOLD
Chapter 3: evidence supporting prevention and maintenance therapy
Chapter 4: management of stable COPD

(一)Patient Care (Case Correlation to ACGME Core Competency Requirements)
Should have empathy, appropriate and effective handling of COPD problems, survey to rule out pulmonary tuberculosis, and monitor his right lower lobe lung tumor lesion.
Provide complete patient care by an interdisciplinary team.

(二) Medical Knowledge (Case Correlation to ACGME Core Competency Requirements)
1.Understand the evaluation of COPD, pulmonary tuberculosis, and lung tumor.
2.Interpret the results of CXR, chest CT, pulmonary function, and sputum AFS & TB culture.
3.Recognize the manifestations of COPD, pulmonary tuberculosis, and lung tumor.
To be able to apply the knowledge learned to the health care of patients.

(三)Practice-Based Learning and Improvement (Case Correlation to ACGME Core Competency Requirements)
Able to review their own patient care status and use EBM (Global Initiative for Chronic Obstructive Lung Disease – GOLD; Global Initiative for Asthma; 結核病診治指引(第六版) - 衛生福利部疾病管制署)techniques to improve the quality of care

(四) Interpersonal and Communication Skills (Case Correlation to ACGME Core Competency Requirements)
1.Discuss the results of blood examinations, lung function, CXR and chest CT with a patient.
2.Discuss the diagnosis of COPD and lung tumor with a patient.
3.Discuss the need for appropriate follow up and monitoring with a patient
4.Comprehensively explain treatment based on disease manifestations
Possess interpersonal and communication skills to effectively convey information. Including communication and interaction skills between doctors and patients and colleagues.

(五) Professionalism (Case Correlation to ACGME Core Competency Requirements)
1. The importance of patient confidentiality and privacy.
2.Understand the need to provide supportive care.
3.Encourage patients to ask questions regarding their disease and empower them to be active participants in their care.
4.Provide adequate time and accessibility to address patient concerns.
5.Demonstrate an understanding of informed consent with regard to the COPD treatment and his lung lesion monitor
Physicians should demonstrate professionalism, respect for others, medical ethics, and sensitivity to different patient groups.

(六) System-Based Practice (Case Correlation to ACGME Core Competency Requirements)
1.Identify barriers to access and delivery of care for patients with complex, multi-system diseases.
2.Learn about resources available to improve delivery of care and patient support.
3.Identify the ways in which one can be a patient advocate, including obtaining prior authorization for medications, treatments, and diagnostic tests.
Effective use of relevant resources to provide appropriate care in accordance with the medical care system.
For example: the norms of health insurance, medical-related operating procedures.