A 64-year-old man with a 45 pack-year smoking history presents with progressive dyspnea and minimal cough. Vital signs: BP 142/88, HR 98, RR 22, SpO2 88% on room air. Physical examination reveals barrel-shaped chest and decreased breath sounds bilaterally. Spirometry shows FEV1/FVC ratio of 58% with markedly decreased DLCO. Chest X-ray demonstrates hyperinflation without focal consolidation. He denies recent infections or hemoptysis. Which diagnosis best explains these findings?
- A)Bronchial asthma
- B)Bronchiectasis
- C)EmphysemaGABARITO
- D)Chronic bronchitis
- E)Pulmonary fibrosis
Explicação
Emphysema causes obstructive physiology with destruction of alveolar septa and loss of elastic recoil. The decreased alveolar surface area lowers DLCO, which helps distinguish emphysema from chronic bronchitis and asthma. The smoking history, barrel chest, and... Ver explicação completa e trilha adaptativa →