Question

A 64 year old man wants to quit smoking. He has a barrel chest, wheezes on expiration, complains of increasing shortness of breath with exertion, and has had to take several courses of antibiotics over the past two years for a productive cough that "never goes away". He sits hunched over in his chair in the doctor's office and obviously uses his chest and neck muscles during respiration. This man is suffering from:

1) Chronic bronchitis
2) Emphysema
3) Chronic obstructive pulmonary disease
4) a-1 antirypsin disease
5) Asthma

Answer 1

The man's symptoms suggest he suffers from Chronic obstructive pulmonary disease (COPD), as indicated by his barrel chest, wheezing, and persistent productive cough, all which are exacerbated by his history of smoking.

Step-by-step explanation:

The 64-year-old man described in the question shows classic symptoms of COPD, which include a barrel chest, wheezing on expiration, shortness of breath with exertion, and a persistently productive cough requiring repeat courses of antibiotics. These symptoms align with Chronic obstructive pulmonary disease, which encompasses both emphysema and chronic bronchitis. Emphysema is characterized by damage to the alveoli and the connective tissue of the lungs, leading to a reduced ability to exhale air completely. The individual's increased use of chest and neck muscles for breathing and the physical presentation further support a COPD diagnosis over other conditions listed. While asthma and A-1 antitrypsin deficiency can present with similar respiratory symptoms, the chronic and progressively worsening nature of this patient's symptoms suggests COPD, particularly given the smoking history.