What physical exam finding is commonly associated with “pink puffer” presentation in patients?

The "pink puffer" presentation is typically associated with emphysema, a type of chronic obstructive pulmonary disease (COPD). Patients with this presentation often exhibit signs such as pursed-lip breathing, a hyperinflated chest, and a barrel-shaped thorax. The term "pink puffer" refers to the pink complexion and the effortful breathing pattern observed in these individuals, who are generally thin and may not have significant changes in their oxygenation until late in the disease process.

The hyperinflated lungs on chest X-ray is a key physical exam finding associated with emphysema. On imaging, the hyperinflation is characterized by increased lung volume, flattened diaphragms, and a more prominent retrosternal air space. This reflects the loss of elasticity in the alveolar walls, leading to trapped air and decreased expiratory airflow.

Other options do not align with the classic "pink puffer" presentation. A productive cough is more characteristic of "blue bloaters," who typically have chronic bronchitis. Clubbing of fingers is not commonly associated with emphysema, as it is often seen in other conditions such as lung cancer or interstitial lung disease. Rales heard upon auscultation usually indicate the presence of fluid