A 22-Year-Old Man Comes to the Office Due to an Intermittent

A 22-year-old man comes to the office due to an intermittent cough for the past 6 months.  He experiences slight wheezing and difficulty breathing, especially in the nighttime and early morning.  The patient has no recent history of fever, chills, rigors, sputum production, or upper respiratory tract infections.  During a basketball game last week, he had an episode of wheezing for which he went to the emergency department; after 2 nebulizer treatments, the wheezing resolved.  He has been otherwise healthy and takes no medications.  The patient does not use tobacco, alcohol, or illicit drugs.  He has lived in the same house for several years and has no pets.  There is no family history of lung disease.  Vital signs are within normal limits.  Lung examination reveals normal tactile fremitus and percussion on both sides.  There are no crackles, wheezing, or other adventitious sounds heard on lung auscultation.  Cardiac examination reveals regular heart sounds with no murmurs.  The posteroanterior and lateral chest radiographs reveal no abnormalities.  What will be the most likely finding on pulmonary function tests?

A) Increased FEV1/FVC ratio
B) Normal testing but an obstructive pattern following methacholine challenge
C) Normal testing but decreased diffusing capacity of the lungs for carbon monoxide (DLCO)
D) Reduced FEV1/FVC and reduced DLCO
E) Reduced total lung capacity with normal FEV1/FVC

Correct Answer:

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