ca-mccqe1 MCQ (SBA): Chronic obstructive pulmonary disease

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A 67-year-old man who smoked one pack per day for 40 years and quit 5 years ago presents with chronic exertional dyspnoea, daily productive cough, and frequent winter bronchitis. Spirometry after bronchodilator shows FEV1/FVC 0.62. What is the most likely diagnosis?

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