06-06-2009, 11:05 AM
A 66-year-old man with a 70 pack year smoking history and a chronic mildly productive morning cough for the past 6 years seeks medical attention from his regular physician for breathlessness that first appeared 4 months ago and now occurs with only minimal exertion. He has no associated dizziness, headache, visual disturbances, chest pain, or focal numbness or weakness. He has always been healthy except for his cough and he quit smoking 8 years ago. He walked briskly for 1 mile every day in the evening before his breathlessness appeared. On physical examination the man is thin and breathing through pursed lips. Significant findings are hyperresonance on chest percussion and markedly quiet heart sounds. Chest x-ray (CXR) shows hyperlucent lung fields with a small heart and flat diaphragms. What pulmonary function results would support the most likely diagnosis?
A. Decreased FEV1 /FVC, increased total lung capacity, decreased residual volume, increased diffusing capacity of lung for carbon monoxide (DLCO)
B. Decreased FEV1 /FVC, increased total lung capacity, increased residual volume, decreased DLCO
C. Decreased FEV1 /FVC, increased total lung capacity, increased residual volume, increased DLCO
D. Normal FEV1 /FVC, decreased total lung capacity, decreased residual volume, increased DLCO
E. Normal FEV1 /FVC, decreased total lung capacity, increased residual volume, decreased DLCO
A. Decreased FEV1 /FVC, increased total lung capacity, decreased residual volume, increased diffusing capacity of lung for carbon monoxide (DLCO)
B. Decreased FEV1 /FVC, increased total lung capacity, increased residual volume, decreased DLCO
C. Decreased FEV1 /FVC, increased total lung capacity, increased residual volume, increased DLCO
D. Normal FEV1 /FVC, decreased total lung capacity, decreased residual volume, increased DLCO
E. Normal FEV1 /FVC, decreased total lung capacity, increased residual volume, decreased DLCO