Mrs Dickerson is a 51 year old

Mrs Dickerson is a 51 year old female who presents for evaluation of shortness of breath with activity. She says she is tired all of the time anymore, and just has no energy or appetite. She never smoked, has no significant occupational exposures and no underlying cardiopulmonary disease. According to her chart she has lost 10 pounds in the last three months without trying. Her lungs auscultate for some diffuse crackles but are otherwise normal. A chest radiograph is essentially normal. Spirometric assessment is as shown below. The AGACNP knows that the next step in the diagnostic evaluation should be FVC-85%predicted Fev1- 82% predicted RV- 60% predicted FRC – 69% predicted TLC -70% Predicted A. A pulmonary consultation B. High resolution chest CT C. A 12 Lead ECG D. An echocardiogram

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