A 68-year-old male smoker presents with progressive exertional dyspnea and chronic morning productive cough. Spirometry demonstrates a post-bronchodilator FEV1/FVC ratio of 0.58 and FEV1 of 62% predicted. Which classification defines this finding?

Answer and explanation

Correct answer: C. COPD with moderate airflow limitation (GOLD 2)

  1. Step 1: A post-bronchodilator FEV1/FVC ratio < 0.70 confirms persistent, irreversible airflow limitation diagnostic of chronic obstructive pulmonary disease (COPD).
  2. Step 2: Under the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, an FEV1 between 50% and 79% predicted corresponds to GOLD 2 (Moderate airflow limitation).
Answer
COPD with moderate airflow limitation (GOLD 2).
Why not the others: 'Normal spirometry' requires FEV1/FVC >= 0.70; 'Severe restrictive ventilatory defect' is characterized by reduced total lung capacity (TLC) with normal or elevated FEV1/FVC ratio; 'Asthma with complete bronchodilator reversibility' requires normalization of FEV1/FVC after bronchodilator inhalation.

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