04-25-2007, 09:18 AM
A 56-year-old woman has had a cough nonproductive of sputum for 2 weeks with no other respiratory or systemic symptoms. She comes to the physician™s office because she has begun to have shortness of breath when climbing one flight of stairs. She has had rheumatoid arthritis for several years, and her condition has been stabilized with anti-inflammatory agents. She has never smoked cigarettes. The physical examination shows early inspiratory crackles.
The results of pulmonary function tests indicate moderately severe airflow obstruction, as follows:
Forced vital capacity (FVC) 2.89 L (81% of predicted)
Forced expiratory volume in 1 sec (FEV1) 1.35 L (47% of predicted)
FEV1 (after bronchodilator) 1.34 L (46% of predicted)
Ratio of FEV1 to FVC 0.47 (63% of predicted)
Carbon monoxide diffusing capacity (DLco) 21.5 mL (80% of predicted)
The chest radiographic findings are normal.
Which of the following is the most likely diagnosis?
(A) Lymphangioleiomyomatosis
(B) Bronchiolitis obliterans
© Asthma
(D) Chronic bronchitis with airflow obstruction
(E) a1-Antitrypsin deficiency
The results of pulmonary function tests indicate moderately severe airflow obstruction, as follows:
Forced vital capacity (FVC) 2.89 L (81% of predicted)
Forced expiratory volume in 1 sec (FEV1) 1.35 L (47% of predicted)
FEV1 (after bronchodilator) 1.34 L (46% of predicted)
Ratio of FEV1 to FVC 0.47 (63% of predicted)
Carbon monoxide diffusing capacity (DLco) 21.5 mL (80% of predicted)
The chest radiographic findings are normal.
Which of the following is the most likely diagnosis?
(A) Lymphangioleiomyomatosis
(B) Bronchiolitis obliterans
© Asthma
(D) Chronic bronchitis with airflow obstruction
(E) a1-Antitrypsin deficiency