A 38-year-old man comes to the office due to progressive shortness of breath for the past several months. The patient gets winded when carrying groceries up a flight of stairs and when walking 2-3 city blocks. He also has a frequent cough productive of thick yellow sputum, especially in the morning. The patient has no other medical conditions. He says he smoked cigarettes occasionally during college, but recently he has been smoking 3 or 4 cigarettes daily after he began work at a new company 2 years ago. The patient does not use alcohol or illicit drugs.
Blood pressure is 124/72 mm Hg and pulse is 84/min. Oxygen saturation is 96% on room air. Lung auscultation reveals occasional expiratory wheezes and rhonchi. There are no heart murmurs. Chest x-ray reveals hyperinflated lungs. Spirometry shows the following:
Which of the following additional testing is most appropriate for this patient?
Definitions:
Smallest Term
The term within a mathematical expression, sequence, or series that has the least value.
Ratio
A mathematical representation of the relationship between two numbers or quantities, indicating how many times one is as large as the other.
Lowest Terms
The expression of a fraction in its simplest form, where the numerator and denominator are as small as possible.
Ratio
A mathematical way to compare two quantities, indicating how many times one value contains or is contained within the other.
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