Mr. JKL is a 69 yr old white male complaining of shortness of breath during activities and sometimes at rest. He does not report any myocardial ischemia symptoms and is treated for hypertension and prostate cancer (diagnosed 5 years prior). The patient quit smoking 3 years ago and smoked on average 2 packs per day for 51 years. He was admitted to the hospital 4 months ago due to respiratory symptoms. The patient is not on supplemental oxygen, his oxygen saturation is 95%, and he reports some shortness of breath with a dyspnea rating of 5 (1-7 scale). The patient is sedentary, rarely walks outside of his home, and does not engage in sports or recreational activities. Mr. JKL's preexercise medical exam results: BMI = 31.8 Resting heart rate = 85 Blood pressure = 144/98 Enlarged anteroposterior chest diameter and decreased breath sounds and prolonged exhalation Current medications: Atrovent inhaler 8 puffs twice per day Doxapram HCL, 50 mg 3 times daily Furosemide, 40 mg 4 times daily Hytrin, 2 mg 4 times daily Prednisone 5 mg 4 times daily Proventil 0.5% twice daily Theo-Dur, 300 mg twice daily Ventolin inhaler 2 puffs twice per day Pulmonary Function Test Results: FVC = 5.31 L (137% of predicted) FEV1 = 1.6 L (49% of predicted) FEV1/FVC = 30% Maximal voluntary ventilation = 77 L (60% of predicted) After the administration of 200 mg albuterol, FVC and FEV1 improved. Diagnosis Stage _________ COPD with dyspnea and exertion Obesity Hypertension Physical deconditioning Answer the following questions in 4 to 6 sentences. 1. According to the American Thoracic Society, which COPD stage is the patient at given his pulmonary function test results? How would the results of this patient's graded exercise test be different from those of a healthy nonsmoker?
Mr. JKL is a 69 yr old white male complaining of shortness of breath during activities and sometimes at rest. He does not report any myocardial ischemia symptoms and is treated for hypertension and prostate cancer (diagnosed 5 years prior). The patient quit smoking 3 years ago and smoked on average 2 packs per day for 51 years. He was admitted to the hospital 4 months ago due to respiratory symptoms. The patient is not on supplemental oxygen, his oxygen saturation is 95%, and he reports some shortness of breath with a dyspnea rating of 5 (1-7 scale). The patient is sedentary, rarely walks outside of his home, and does not engage in sports or recreational activities.
Mr. JKL's preexercise medical exam results:
BMI = 31.8
Resting heart rate = 85
Blood pressure = 144/98
Enlarged anteroposterior chest diameter and decreased breath sounds and prolonged exhalation
Current medications:
Atrovent inhaler 8 puffs twice per day
Doxapram HCL, 50 mg 3 times daily
Furosemide, 40 mg 4 times daily
Hytrin, 2 mg 4 times daily
Prednisone 5 mg 4 times daily
Proventil 0.5% twice daily
Theo-Dur, 300 mg twice daily
Ventolin inhaler 2 puffs twice per day
Pulmonary Function Test Results:
FVC = 5.31 L (137% of predicted)
FEV1 = 1.6 L (49% of predicted)
FEV1/FVC = 30%
Maximal voluntary ventilation = 77 L (60% of predicted)
After the administration of 200 mg albuterol, FVC and FEV1 improved.
Diagnosis
Stage _________ COPD with dyspnea and exertion
Obesity
Hypertension
Physical deconditioning
Answer the following questions in 4 to 6 sentences.
1. According to the American Thoracic Society, which COPD stage is the patient at given his pulmonary function test results? How would the results of this patient's graded exercise test be different from those of a healthy nonsmoker?
2. What classes of medications is this patient on and why?
3. What were the results of his pulmonary function test and what physiological factors account for this?
4. Would an exercise program improve these pulmonary function tests? Why or why not?
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