Your next patient has a 1 pack

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? #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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