10th September 2020

A 59-year-old man presents to the Medical Admissions Unit complaining of a two-day history of worsening dyspnoea

A 59-year-old man presents to the Medical Admissions Unit complaining of a two-day history of worsening dyspnoea and a change in his productive cough. He describes his sputum as yellow in colour, which was previously clear, and denies any chest pain, haemoptysis or weight loss. He has been a smoker for 35 years and continues to smoke a packet of cigarettes daily despite cessation advice. Respiratory examination reveals widespread wheeze and reduced air entry.

His basic observations are: T 37.7, Oxygen saturations 90%, RR 25, HR 95, BP 145/95

You perform an ABG and the results are: 

• pH – 7.29 (7.35 – 7.45)
• PaO₂ – 7.4 kPa (11 – 13 kPa)
• PaCO₂ – 7.2 kPa (4.7 – 6.0 kPa)
• HCO₃⁻ – 30 mEq/L (22 – 26 mEq/L)

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.