Respiratory Case Histories - Case 13 A 150 lb., 62-year-old man had a chronic productive cough, exertional...

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Medical Sciences

Respiratory Case Histories - Case 13
A 150 lb., 62-year-old man had a chronic productive cough,exertional dyspnea, mild cyanosis, and marked slowing of forcedexpiration. His pulmonary function and laboratory tests follow:
Frequency 16 breaths/min
Alveolar ventilation 4.2 L/min
Vital capacity (VC) 2.2 L
Functional residual capacity (FRC) 4.0 L
Total lung capacity (TLC) 5.2 L
Maximum inspiratory flow rate 250 L/min
Maximum expiratory flow rate 20 L/min
PaO2 62 mm Hg
PaCO2 39 mm Hg
Pulmonary function tests after bronchodilator therapy:
Frequency 16 breaths/min
Alveolar ventilation 4.35 L/min
VC 2.4 L
FRC 4.0 L
TLC 5.2 L
Maximum inspiratory flow rate 250 L/min
Maximum expiratory flow rate 23 L/min
PaO2 62 mm Hg
PaCO2 38 mm Hg
1. What is the disorder of this 62-year-old man?
2. Is this primarily a restrictive or an obstructive disorder?Why?
3. Why is the bronchodilator therapy ineffective in thisman?
4. What causes the hypoxemia?
6. What is the cause of this altered RV?
7. Calculate the tidal volume (TV) for this person before andafter the bronchodilator therapy.
8. Is each TV normal or altered?
9. Calculate the minute ventilation (MV) for this person beforeand after the bronchodilator therapy.
10. Is each MV normal or altered?

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4.4 Ratings (874 Votes)

This patient is likely to be suffering from chronic obstructive airway disease Explanation History Productive cough as airways are inflamed Exertional dyspnea Signs cyanosis Pulmonary function Reduce forced expiration FEV Reduced expiratory flow rate which improved with bronchodilator therapy Reduced vital capacity which improved with bronchodilator therapy Functional residual volume is high All these factors point towards an See Answer

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Frequency	16 breaths/min
Alveolar ventilation	4.2 L/min
Vital capacity (VC)	2.2 L
Functional residual capacity (FRC)	4.0 L
Total lung capacity (TLC)	5.2 L
Maximum inspiratory flow rate	250 L/min
Maximum expiratory flow rate	20 L/min
PaO2	62 mm Hg
PaCO2	39 mm Hg