A 60-year-old man comes to his physician because of worsening exertional dyspnea for the past 2 months. He also occasionally has a dry cough. He has not had fever, chills, or night sweats. The patient does not use alcohol or illicit drugs and he has smoked one pack of cigarettes daily for the past 30 years. He is 183 cm (6 ft 0 in) tall and weighs 66 kg (145 lbs); BMI is 20 kg/m2. His temperature is 37°C (98.6°F), pulse is 94/min, respirations are 21/min, and blood pressure is 136/88 mm Hg. Lung auscultation reveals a prolonged expiratory phase and end-expiratory wheezing. This patient's pulmonary function testing will most likely show which of the following patterns of findings?

Question

A 60-year-old man comes to his physician because of worsening exertional dyspnea for the past 2 months. He also occasionally has a dry cough. He has not had fever, chills, or night sweats. The patient does not use alcohol or illicit drugs and he has smoked one pack of cigarettes daily for the past 30 years. He is 183 cm (6 ft 0 in) tall and weighs 66 kg (145 lbs); BMI is 20 kg/m2. His temperature is 37°C (98.6°F), pulse is 94/min, respirations are 21/min, and blood pressure is 136/88 mm Hg. Lung auscultation reveals a prolonged expiratory phase and end-expiratory wheezing.   This patient's pulmonary function testing will most likely show which of the following patterns of findings?

Quizplus · Accepted Answer

Eductional Objective: Chronic obstructive pulmonary disease is a combination of emphysema and chronic bronchitis and commonly presents with progressive dyspnea and recurrent upper respiratory infections.  Bronchial obstruction and alveolar destruction cause air trapping that manifests on pulmonary function testing as decreased forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio.  Residual volume and total lung capacity are increased.

A 60-Year-Old Man Comes to His Physician Because of Worsening