08-10-2015, 06:23 PM
A 57 year old woman comes to the physician because of a 2 year history of progressive cough productive of 2 to 3 tablespoons of yellow sputum daily; it is worse in the morning and now lasts all day. She cannot walk more than one block without becoming short of breath. She has not had fever, hemoptysis, night sweats, nor weight loss. She has smoked 2 packs of cigarettes daily for 40 years. She is 160 cm (5 ft 3 in) tall and weighs 82 kg (180 lb); BMI is 32. Her pulse is 96, respirations are 20, and blood pressure is 150/90. Pulse oximetry on room air shows an oxygen saturation of 90%. Breath sounds are decreased in all lung fields, and ronchi are heard at the bases. The expiratory phase is prolonged. An ECG show sinus tachycardia and P pulmonale. Pulmonary function tests show an FEV1 of greater than 80% of predicted, an FEV1:FVC ratio of 70% of predicted, and a diffusing capacity of the lung for carbon monoxide greater than 60% of predicted. Which of the following is the most likely diagnosis?
A) Chronic bronchitis
B) Cystic fibrosis
C) Emphysema
D) Kartagener's syndrome
E) Postnasal drip syndrome
A) Chronic bronchitis
B) Cystic fibrosis
C) Emphysema
D) Kartagener's syndrome
E) Postnasal drip syndrome