QuestionSBA
QuestionChoice
Despite a history of smoking and the presence of clubbing, there are no further indications of lung cancer such as red flag symptoms or extrapulmonary features. Furthermore, this patient has a dry cough, crackles, clubbing and is a 70-year-old smoker: this is a typical presentation of IPF.
10003504
d
Lung carcinoma
QuestionChoice
There are no risk factors for TB in this question (i.e. travel abroad, unwell contacts). Furthermore, this patient has a dry cough, crackles, clubbing and is a 70-year-old smoker: this is a typical presentation of IPF.
10003505
e
Pulmonary tuberculosis
QuestionChoice
Patients with bronchiectasis often have a chronic mucopurulent cough, exertional dyspnoea and occasionally have haemoptysis.

They can also present with an acute infective exacerbation. If this patient did have an infection, his symptomatic history would be much shorter, he would be pyrexic, and be producing purulent sputum.
10003502
b
Bronchiectasis
QuestionChoice
There is no indication of allergy or exposure to irritants (coal, dust, chemicals) in this question. Furthermore, this patient has a dry cough, crackles, clubbing, and is a 70-year-old smoker: this is a typical presentation of IPF.
10003503
c
Extrinsic allergic alveolitis
QuestionChoice
This patient has a dry cough, crackles, clubbing and is a 70-year-old smoker. This is a typical presentation of IPF.
10003501
a
Idiopathic pulmonary fibrosis (IPF)
Concept
Chapter
2693
3719
Bronchiectasis
Topic
132
Respiratory
13247
A 70-year-old male has a seven-month history of dry cough and increasing dyspnoea. He was previously fit and well and is an occasional smoker. His temperature is 36.3°C, pulse 60 bpm and oxygen saturations are 88% on air.

On examination, there is finger clubbing and on respiratory examination, you auscultate bibasal crepitations.

Which of the following options is the most likely diagnosis?
a