A 56-Year-Old Man Comes to the Office Due to Progressively

A 56-year-old man comes to the office due to progressively worsening exertional dyspnea over the last 4 months.  The patient has had no fever, chest pain, orthopnea, cough, or ankle swelling.  He does not use tobacco, alcohol, or illicit drugs.  The patient works for a home insulation and plumbing company.  He has never been abroad and owns no pets.  Medications include hydrochlorothiazide and amlodipine for blood pressure control.  Temperature is 36.8 C (98.2 F) , blood pressure is 130/78 mm Hg, pulse is 76/min, and respirations are 15/min.  Examination shows digital clubbing and fine bibasilar end-inspiratory crackles.  Jugular venous pressure is 2 cm H₂O above the sternal angle.  There is no peripheral edema.  Which of the following additional findings is most likely to be found in this patient?

A) Decreased diffusion capacity of the lung
B) Decreased pulmonary arterial pressure
C) Increased pulmonary capillary wedge pressure
D) Increased residual lung volume
E) Reduced FEV1/FVC ratio

Correct Answer:

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