Which of the following indicates a more severe case of COPD when measured?

• A. FEV1 is above predicted value
• B. FEV1 is equal to predicted value
• C. FEV1 is less than predicted value
• D. FEV1 is normal

Answer: (C)

In the context of Chronic Obstructive Pulmonary Disease (COPD), the Forced Expiratory Volume in one second (FEV1) is a critical measurement used to assess the severity of airflow obstruction. A reduced FEV1 compared to predicted values indicates greater impairment of pulmonary function, which correlates with the severity of the disease.

When FEV1 is less than the predicted value, it signifies that the patient's ability to expel air from their lungs is significantly compromised, reflecting more severe disease progression. This reduction can lead to increased dyspnea, decreased exercise tolerance, and limitations in activities of daily living.

In contrast, if FEV1 is equal to or above the predicted value, it suggests that the individual has a preserved lung function, which is characteristic of less severe or controlled states of lung health. Normal FEV1 would indicate no significant obstruction. Therefore, a measurement of FEV1 that is less than the predicted value clearly aligns with a more dangerous and advanced case of COPD, as it reveals a higher degree of airflow limitation and impairment.