Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe hyperinflation is similar to multiple prior studies consistent with underlying COPD . A right pleural effusion is small . Chronic bilateral rib and clavicular fractures are unchanged . There is no pneumothorax , pulmonary vascular congestion , or focal consolidation .
    OUTPUT:
    
1 . No focal consolidation . 2 . Severe hyperinflation consistent with COPD . 3 . Small right pleural effusion , new from the most recent prior study .