A 67-year-old man presents to your office with worsening cough, sputum production, and shortness of breath. He has been a cigarette smoker for the past 50 years, smoking approximately 1 pack a day. He has a chronic AM cough productive of some yellow sputum but generally feels okay during the day. He was in his usual state of health until two weeks ago when he developed a cold. Since then, he has had a hacking cough and increased thick sputum production. He also has had difficulty walking more than a block without stopping due to shortness of breath. Physical examination reveals prolonged expiration, audible wheezing, and diffuse rhonchi throughout both lung fields. Chest x-ray shows hyperinflation of both lungs with a flattened diaphragm. A. What are the two major clinical syndromes classified as chronic obstructive pulmonary disease? How do they differ?
B. Of the two syndromes above, which is predominant in this patient? What are the epidemiology and predisposing factors for this condition?
C. What might the pulmonary function tests show in this patient?
D. How do arterial blood gases differ in chronic bronchitis and emphysema?