Clinical features

• a previous history of COPD ^{a b} 
• smoking ^a and how much for how long ^a  
• previous exacerbations ^b  
• cough ^a  and any recent increase ^d
• wheezing ^a and any recent increase ^d
• exertional dyspnoea ^a
• sputum production  ^a and any recent increase or purulence ^d

• a maximum laryngeal height > 4 cm ^a
  (the distance between the top of the thyroid cartilage and the suprasternal notch)
• a barrel chest
• subxyphoid cardiac apical pulse
• decreased cardiac dullness on percussion
• decreased breath sounds
• wheezing
• crackles
• hyperresonance 
• a prolonged expiratory time ^a  

Note clinical examination cannot safely diagnose or exclude COPD ^a