Question 9

9.  Your patient present to your office after notice a 18 month history of progressively worsening shortness of breath. You have sent him for outpatient pulmonary function tests.  Based on the data below, what is the best management option?

Pre Bronchodilator
FVC     49% Prediceted
FEV1   47% Predicted
TLC     45% Predicted
RV       42% Predicted


Post Bronchodilator
FVC     47% Predicted
FEV1   45% Predicted
DLCO 38% Predicted


A. Start the patient a burst of Prednisone and re-evaluate the patient in a month to see if they responded.

B. Start the patient on albuterol 4 times a day with an inhaled glucocorticoid

C.  Start the patient on singulair 10 mg daily

D.  Start the patient in Pulmonary Rehabilitation and refer to patient to pulmonary.

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