Week 3 Case Study Template Pathophysiology & Clinical Findings of the Disease 1.Are the spirometry results consistent with obstructive or restrictive pulmonary disease? What is the most likely pulmonary diagnosis for this patient?

Spirometry testing is made up of several numbers, those that play a vital part in interpretation include the forced volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and total lung capacity (McCance, 2019). With the given spirometry results, we assess the FEV1/FVC ratio, in obstructive the ratio is less than 70%, restrictive is greater than 70% (Haynes, 2018). From this alone, we can determine that this is an obstructive disorder. By comparing the FEV1 pre-bronchodilator and post-bronchodilator, we can determine that this is a non-reversible obstructive disease, most likely chronic obstructive pulmonary disease (COPD) (Haynes, 2018). 2.Explain the pathophysiology associated with the chosen pulmonary disease. In COPD, individuals have hyperinflated lungs from a combination of chronic bronchitis and emphysema. These conditions combine to cause mostly irreversible abnormalities in the bronchi and alveoli that obstruct airflow (McCance, 2019). With chronic bronchitis, prolonged mucus and pus collection are the initial offender causing obstruction, but with consistent inflammation from this accumulation smooth muscles become fibrosed, narrowing airways, and causing irreversible obstruction (McCance, 2019). In emphysema, the alveoli walls are destroyed when there is "an imbalance of proteases and antiproteases" (McCance, 2019). This imbalance also increases neutrophils, macrophages, and T cells that all play a role in cellular apoptosis or cell breakdown (McCance, 2019). This breakdown of cells, decreases the surface area for gas exchange (McCance, 2019). Both of these conditions contribute to a mismatch in the ventilation and perfusion which leads to hypoxemia (McCance, 2019). In COPD, air becomes trapped in the lungs due to a combination of the above, also causing hyperinflation of the lungs