# Case 18: The breathless blues.

**URL:** <https://www.medboundhub.com/t/case-18-the-breathless-blues/3000>\
**Category:** MBBS\
**Tags:** explore, futuredoctors, mbbs, medical\
**Created:** [June 10, 2025, 7:00am UTC](https://www.medboundhub.com/t/case-18-the-breathless-blues/3000 "2025-06-10T07:00:23Z")\
**Posts on this page:** 2\
**Page:** 1

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**Author:** ![Hrishikeshmed](https://yyz1.discourse-cdn.com/flex033/user_avatar/www.medboundhub.com/hrishikeshmed/32/346_2.png) [@Hrishikeshmed](https://www.medboundhub.com/u/Hrishikeshmed)\
**Post date:** [June 10, 2025, 7:00am UTC](https://www.medboundhub.com/t/case-18-the-breathless-blues/3000/1 "2025-06-10T07:00:23Z")

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A 70-year-old man with a 40-pack-year smoking history presents with progressive shortness of breath, chronic cough, and frequent sputum production over the past two years. He reports difficulty climbing stairs and a recent increase in fatigue. On auscultation, there are decreased breath sounds and scattered wheezes bilaterally. A chest X-ray shows hyperinflated lungs with flattened diaphragms. What is the most likely diagnosis, and what is the typical pattern of pulmonary function tests in this condition?

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**Author:** ![Manisha](https://avatars.discourse-cdn.com/v4/letter/m/6f9a4e/32.png) [@Manisha](https://www.medboundhub.com/u/Manisha)\
**Post date:** [June 10, 2025, 3:20pm UTC](https://www.medboundhub.com/t/case-18-the-breathless-blues/3000/2 "2025-06-10T15:20:51Z")

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The most likely diagnosis is **Chronic Obstructive Pulmonary Disease (COPD)**, likely emphysema predominant.