-In the months preceding her visit to the clinic, the patient reported producing one to one and a half cups of sputum daily and requiring 2.5 liters of supplemental oxygen per minute for 12 hours each night. During her visit, she complaining of a stabbing chest pain, Shortness of breath.
-Upon pulmonary examination, bilateral breath sounds were audible with few expiratory wheezes at the lung bases; there were no rales. Chest x-rays revealed very prominent bronchial markings consistent with chronic bronchitis and possibly bronchiectasis; no acute infiltrates were identified. Pulmonary function tests (Table 1) indicated a markedly increased residual volume, slightly elevated total lung capacity, and moderately decreased transport factor (diffusion capacity)