Which term describes COPD with destruction of alveoli and outward flow impairment, often with pursed-lip breathing and relatively preserved oxygenation?

• A. Pink puffer
• B. Blue bloater
• C. Barrel chest
• D. Wheeze

Answer: (A)

The main concept is recognizing the emphysema phenotype of COPD, where alveolar walls are destroyed, elastic recoil is lost, and air gets trapped during expiration. This outward flow impairment leads to hyperinflation, and patients often adopt pursed-lip breathing to keep the airways from collapsing as they exhale. Because oxygenation can stay relatively good early on, they are typically not cyanotic and may appear pink. This combination—alveolar destruction, air trapping, pursed-lip breathing, and preserved oxygenation—fits the nickname pink puffer.

In contrast, the term blue bloater describes the chronic bronchitis phenotype, with cyanosis and often weight gain or edema from chronic hypoxemia. A barrel chest is a sign of hyperinflation but is not the descriptor for the COPD type, and wheeze is a symptom rather than a specific disease label.