USMLE UWorld Q 7601 Respiratory physiology

[maggiesilverchow]

Pt evaluated for worsening SOB on exertion, 40-pack-year smoking hit. Lung are hyperresonant on percussion and there is diffuse wheezing on auscultation. CXR reveals a flattened diaphragm with a narrow mediastinum, there are decreased bronchovascular markings in the peripheral lung region.
Why this is COPD? how to tell it is not restrictive lung diseases ?

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[CyrusHabs7695]

flattening of diaphragm, smoking, wheezing are all indicative of emphysema

 

[stickgirl390]

Flattened diaphragm and narrowed mediastinum indicate air trapping that can’t get out of the lungs, which is characteristic of obstructive rather than restrictive lung diseases.