Which feature is characteristic of the emphysema phenotype of COPD?

• A. Pink complexion
• B. Cyanosis
• C. Peripheral edema
• D. Obesity

Answer: (C)

Emphysema tends to present with a pink complexion because oxygenation is relatively preserved early on, even though there is severe dyspnea and air trapping. This classic “pink puffer” appearance arises from hyperinflation and increased work of breathing rather than chronic hypoxemia. Cyanosis is more typical of chronic bronchitis, where low oxygen levels are common. Peripheral edema indicates right heart strain or advanced disease and is not a defining feature of the emphysema phenotype. Obesity is not characteristic; many patients with emphysema are underweight due to increased energy expenditure from labored breathing. Therefore, the pink complexion best reflects the emphysema phenotype.