system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 62-year-old man is brought to the emergency department because of progressive shortness of breath, mild chest pain on exertion, and a cough for 2 days. One week ago, he had a low-grade fever and nasal congestion. He has hypertension but does not adhere to his medication regimen. He has smoked one pack of cigarettes daily for 30 years and drinks 3–4 beers daily. His temperature is 37.1°C (98.8°F), pulse is 125/min, respirations are 29/min, and blood pressure is 145/86 mm Hg. He is in moderate respiratory distress while sitting. Pulmonary examination shows reduced breath sounds bilaterally. There is scattered wheezing over all lung fields. There is inward displacement of his abdomen during inspiration. Arterial blood gas analysis shows:
pH 7.29
PCO2 63 mm Hg
PO2 71 mm Hg
HCO3- 29 mEq/L
O2 saturation 89%
Which of the following is the most likely cause of this patient's symptoms?"
assistant
Acute exacerbation of chronic obstructive pulmonary disease