Review Question - QID 215012

A 55-year-old man presents to the primary care clinic complaining of progressive fatigue with exertion. He used to walk 1.5 miles every morning, but over the past year, his activity tolerance has progressively worsened and now he cannot take more than 10 steps without sitting to catch his breath. He denies orthopnea. The patient has a history of heart failure and is on lisinopril, metoprolol, and spironolactone. He currently smokes 1 pack of cigarettes per day and has done so for 40 years. The patient’s temperature is 98.6°F (37.0°C), blood pressure is 118/78 mmHg, pulse is 92/min, respirations are 12/min, and oxygen saturation is 88% on room air. Physical exam reveals a thin-appearing man with reduced bilateral breath sounds and muffled heart sounds without peripheral edema. Figure A shows spirometry results. Figure B shows a diagram of lung volumes and capacities. Which of the following changes in lung volumes/capacities are most consistent with the patient’s underlying pathology?