Which label is traditionally associated with emphysema due to smoking?

• A. Blue bloater
• B. Pink puffer
• C. Barrel-chested
• D. Chronic bronchitis

Answer: (B)

Emphysema from smoking is traditionally described as the pink puffer. The nickname captures two features: pink, because oxygenation is relatively preserved early on, and puffer, because patients breathe with pursed lips to keep airways open and improve expiratory flow. The disease causes air trapping and hyperinflation, so lungs look overexpanded and patients often have marked dyspnea and a lean appearance due to cachexia. In contrast, blue bloater refers to chronic bronchitis, where cyanosis and often overweight status with edema and productive cough predominate. While barrel-chested is a sign of hyperinflation, the familiar label tied to smoking-related emphysema is pink puffer.