QuestionSBA
QuestionChoice
This diagnosis is not the most likely considering the history given. There is no mention of a fever or purulent sputum.
10003883
c
Pneumonia
QuestionChoice
This is the most likely diagnosis considering the patient's history and the obstructive findings on spirometry (FEV1/FVC ratio <0.7).
10003881
a
COPD
QuestionChoice
Whilst this patient is high risk for lung malignancy, there are no red flags mentioned in the history, such as weight loss or haemoptysis.
10003884
d
Lung malignancy
QuestionChoice
Whilst asthma can present with exertional dyspnoea and wheeze, it is more associated with a dry cough. Furthermore, there is no mention in the history of symptom variability. The significant smoking history makes COPD more likely.
10003882
b
Asthma
QuestionChoice
Pulmonary fibrosis typically presents with a dry cough and persistent, progressive dyspnoea that is worse on exertion. Pulmonary fibrosis is also associated with a restrictive profile on spirometry (reduced FVC, normal FEV1/FVC), not obstructive.
10003885
e
Pulmonary fibrosis
Concept
Chapter
2693
3726
Spirometry
Topic
132
Respiratory
13323
A 67-year-old man attends a respiratory outpatient clinic with long-term exertional dyspnoea, wheeze and a chronic productive cough. He is calculated to have a 40-pack-year smoking history. He undergoes spirometry testing: his FEV1/FVC ratio is 0.5.

Which of the following is the most likely diagnosis?
a