A 67-year-old man presents to your office with worsening cough, sputum production, and shortness of.

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
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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.

Questions

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?

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