Which of the following is a presentation of COPD in chronic bronchitis?

• A. Obesity
• B. Peripheral edema
• C. Wheezing/prolonged expiration
• D. Cyanosis

Answer: (D)

Chronic bronchitis, a form of COPD, often presents with hypoxemia because long-standing airway inflammation and mucus plugging impair gas exchange. That chronic low oxygen level can cause a bluish tint to the lips and face, known as cyanosis. This cyanosis—the “blue bloater” picture—reflects the ventilation–perfusion mismatch and is a characteristic sign of this phenotype. While wheezing and prolonged expiration are common in COPD as a whole due to airway obstruction, and edema can occur with evolving heart strain, cyanosis best signals the chronic hypoxemia specific to chronic bronchitis. Obesity is not a defining feature of this presentation.