QuestionSBA
QuestionChoice
This is an obstructive lung condition with reversible bronchoconstriction. It would be less common to see a presentation of asthma for the first time in a 78-year-old. The spirometry would show an obstructive pattern with an FEV1/FVC ratio of <0.7.
10000238
c
Asthma
QuestionChoice
COPD is a chronic irreversible obstruction to the airways. This patient fits the typical presentation for COPD. He is a smoker and has a chronic cough productive of phlegm and dyspnoea. A common aetiology of COPD is smoking alongside air pollutants. The spirometry would show an obstructive pattern with an FEV1/FVC ratio of <0.7.
10000236
a
Chronic obstructive pulmonary disease (COPD)
QuestionChoice
This is a restrictive lung condition and so the FEV1/FVC ratio would appear normal (0.7) despite the individual values being lower. Patients also exhibit a dry cough rather than productive, dyspnoea and fatigue.
10000240
e
Pulmonary fibrosis
QuestionChoice
This is a permanent dilatation of the bronchi due to chronic infection. A productive cough, purulent sputum and haemoptysis would be symptoms of bronchiectasis. Bronchiectasis would show an obstructive type spirometry of <0.7.
10000239
d
Bronchiectasis
QuestionChoice
This is an inflammatory condition caused by infection and often caused by streptococcus pneumonia in the community. It can also be hospital-acquired or due to aspiration. Pneumonia can show a restrictive type pattern in spirometry with a normal FEV1/FVC ratio.
10000237
b
Pneumonia
Concept
Chapter
2693
3717
Chronic obstructive pulmonary disease (COPD)
Topic
132
Respiratory
12594
A 78-year-old male presented to his GP with a chronic productive cough and difficulty breathing. He has been a smoker for 50 years. Spirometry shows an FEV1/FVC ratio of 0.5.

Which of the following is the most likely diagnosis?
a