Your next patient has a 1 pack day history for 25 years. BV has bilateral crackles when you assess his lungs. BV states he had a recent hospital admission for shortness of breath, producti

Your next patient has a 1 pack day history for 25 years. BV has bilateral crackles when you assess his lungs. BV states he had a recent hospital admission for shortness of breath, productive cough, & weakness. He was diagnosed with an upper respiratory infection. He has been home for 2 days and still feels fatigue. He was on a course of antibiotics during admission.
Post bronchodilator spirometry results & CXR
Test Result (% Predicted) % Change
FEV1/FVC 50 7
FEV1 50 8
FVC 50 6
CXR: Impression – Hyperinflation
Interpretation of results?
Interpretation of reversibility/GOLD severity grading?
Most likely diagnosis?
Treatment strategy with rationale?
Question#2
LZ is a 77-year-old male, presenting for evaluation of a productive cough for 6 weeks. He reports he has never smoked or used tobacco products but his wife smoked in the house for about 25 years, during their 40-year marriage. She quit smoking in the house about a year ago. LZ was employed in agriculture for 50 + years.
Post-bronchodilator spirometry test
Test Result (% Predicted) % Change Result
FEV1/FVC 64 4
FEV1 62 3
FVC 61 6
Interpretation of results?
Interpretation of reversibility/GOLD severity grading?
Most likely diagnosis?
Treatment strategy with rationale?

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