Upon pulmonary examination, bilateral breath sounds
were audible with a few expiratory wheezes at the
A polyp was found in the right nostril; there was no
evidence of sinusitis. Other findings were
unremarkable. The examining physician established a
working diagnosis of COPD including components of
emphysema, chronic bronchitis, and possible
bronchiectasis. The overall clinical impression was that of progressive pulmonary decline with anticipated
total disability