A 45-year-old man comes to the physician because of dyspnea on exertion and decreased exercise tolerance. During this period, he has also had difficulty concentrating at work and has experienced generalized fatigue. He has fallen asleep multiple times during important meetings. He has smoked one pack of cigarettes daily for 28 years and drinks one alcoholic beverage per day. BMI is 35 kg/m2. His temperature is 37.1°C (98.8°F), pulse is 88/min, respirations are 14/min, and blood pressure is 145/85 mm Hg. Physical examination shows erythema of the face. He is notable for central obesity. Lungs are clear on auscultation bilaterally. Which of the following changes (forced expiratory volume in 1 second [FEV₁], forced vital capacity [FVC], expiratory reserve volume [ERV], residual volume [RV], and total lung capacity [TLC]) are most likely to be seen on pulmonary function testing in this patient?

Question

Quizplus · Accepted Answer

Eductional Objective: Obesity, particularly morbid, central obesity, can cause a pattern of extrinsic restrictive pulmonary function tests.  The most common indicator of obesity-related disease is a reduction in expiratory reserve volume and functional residual capacity, but forced expiratory volume in 1 second, forced vital capacity, and total lung capacity are also typically decreased.

A 45-Year-Old Man Comes to the Physician Because of Dyspnea