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Question: A 78-year old white female presented to the Emergency Room with shortness of breath. She has along history of smoking and continues to consume 1 pack per day. She has previously been admitted, on several occasions, for shortness of breath. She has chronic dyspnea on exertion but for several days prior to her Emergency Room visit; she had been experiencing increased shortness of breath and a non-productive cough. Chest x-rays showed no infiltrate but there appeared to by hyperinflation and flattening of the diaphragm consistent with Chronic Obstructive Pulmonary Disease (COPD). No wheezing was noted on examination. It was learned that she had discontinued her home medications of Theodur and Proventil inhaler. She was admitted and started on IV Aminophylline, nebulized bronchodilators and steroids. Her medications and the steroids were tapered.
What is the principal diagnosis for this case?
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