A 62-year-old woman with hypertension and type 2 diabetes mellitus comes to the physician because of increasing shortness of breath and a dry cough over the past 6 months. She has smoked 1 pack of cigarettes daily for the past 40 years. Chest auscultation shows scattered expiratory wheezes in both lung fields. Spirometry shows an FEV1:FVC ratio of 65% and an FEV1 of 70% of predicted. Her diffusing capacity for carbon monoxide (DLCO) is 42% of predicted. Which of the following is the most likely diagnosis?
APulmonary fibrosis
BBronchial asthma
CEmphysema
DBronchiectasis
EChronic bronchitis
A previously healthy 64-year-old woman comes to the physician because of a dry cough and progressively worsening shortness of breath for the past 2 months. She has not had fever, chills, or night sweats. She has smoked one pack of cigarettes daily for the past 45 years. She appears thin. Examination of the lung shows a prolonged expiratory phase and end-expiratory wheezing. Spirometry shows decreased FEV1:FVC ratio (< 70% predicted), decreased FEV1, and a total lung capacity of 125% of predicted. The diffusion capacity of the lung (DLCO) is decreased. Which of the following is the most likely diagnosis?
ABronchiectasis
BInterstitial lung disease
CChronic obstructive pulmonary disease
DHypersensitivity pneumonitis
EBronchial asthma
A 57-year-old man presents to the clinic for a chronic cough over the past 4 months. The patient reports a productive yellow/green cough that is worse at night. He denies any significant precipitating event prior to his symptoms. He denies fever, chest pain, palpitations, weight changes, or abdominal pain, but endorses some difficulty breathing that waxes and wanes. He denies alcohol usage but endorses a 35 pack-year smoking history. A physical examination demonstrates mild wheezes, bibasilar crackles, and mild clubbing of his fingertips. A pulmonary function test is subsequently ordered, and partial results are shown below: Tidal volume: 500 mL Residual volume: 1700 mL Expiratory reserve volume: 1500 mL Inspiratory reserve volume: 3000 mL What is the functional residual capacity of this patient?
A4500 mL
B2000 mL
C2200 mL
D3200 mL
E3500 mL
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