Stable Chronic Obstructive Pulmonary Disease
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Abishek Biswas, MD
Interventional Pulmonology, Parkview Regional Medical Center, Fort Wayne, IN.

Question 1 of 5

Questions 1 and 2 are based on the following case:

A 71-year-old man with a history of congestive heart failure, hypothyroidism, and smoking (42 pack-years) is being evaluated for exertional shortness of breath. He undergoes a pulmonary function test that shows a forced expiratory volume in 1 second (FEV1) of 1.15 L (31% predicted), forced vital capacity of 3.4L (67% predicted), FEV1/FVC ratio of 0.34, and diffusion capacity for carbon monoxide of 15.2 mL/mm Hg/min (85% predicted). He has a significant bronchodilator response, with improvement in FEV1 of 300 mL (14%). He is diagnosed with severe obstructive lung disease with a significant bronchodilator response suggestive of chronic obstructive pulmonary disease (COPD). The patient is concerned about his risk of death, specifically from COPD. His cardiologist has given him information on the impact of congestive heart failure on mortality, and he asks for a clear and accurate estimation of his risk of mortality from COPD.

Which of the following clinical factors is not needed to determine this patient’s risk of mortality from COPD?

Body weight and height

Diffusion capacity for carbon monoxide

FEV1

Level of dyspnea according to the Modified Medical Research Council (mMRC) dyspnea score

Six-minute walk distance and exertional tolerance

This quiz is not accredited for CME.

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