Which combination of signs is typical of COPD?

• A. Wheezing only during exercise, normal chest X-ray
• B. Sudden chest pain radiating to arm, shortness of breath
• C. History of smoking, chronic productive cough, prolonged expiratory phase, abnormal lung sounds
• D. Fever, productive cough, unilateral wheeze

Answer: (C)

The signs shown reflect chronic obstructive pulmonary disease, which comes from long-term airway exposure (most often smoking) and leads to ongoing airflow limitation with several telling features.

A history of smoking is a major risk factor and sets the stage for COPD, where the airways and surrounding tissue become inflamed and damaged over years.

A chronic productive cough points to the chronic bronchitis component, where persistent sputum production is common for months and years rather than sudden, short-lived illness.

A prolonged expiratory phase happens because narrowed airways resist air flow during exhalation, causing air trapping and longer time to empty the lungs. This is a hallmark of obstructive processes like COPD.

Abnormal lung sounds—such as wheezes or rhonchi—reflect narrowed airways and secretions. In COPD, auscultation often reveals these changes and may include decreased breath sounds in more advanced emphysema.

Other scenarios describe conditions less consistent with COPD—for example, exercise-induced wheeze with a normal chest X-ray suggests asthma; sudden chest pain with shortness of breath points to a cardiac event; fever with productive cough and unilateral wheeze suggests pneumonia or a localized issue rather than chronic COPD.