A 65-year-old lifelong smoker has a chronic productive cough and exertional breathlessness with an FEV1/FVC of 0.55. What is the most likely diagnosis?
Answer and explanation
Correct answer: B. Chronic obstructive pulmonary disease
- Step 1: The picture of a post-bronchodilator FEV1/FVC below 0.7 fits Chronic obstructive pulmonary disease.
Answer
Chronic obstructive pulmonary disease.
Why not the others: 'Asthma': it has variable airflow limitation that reverses with bronchodilators, often from childhood. 'Bronchiectasis': it gives copious purulent sputum with dilated airways. 'Heart failure': it gives orthopnoea and basal crackles with a normal FEV1/FVC.
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