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Adult asthma — SCE Respiratory MCQ

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EasyAsthmaAdult asthmaSCE Respiratory

A 28-year-old man presents with episodic wheeze and cough after moving into a damp flat. Spirometry shows FEV1/FVC 0.66 and FEV1 improves by 18% and 420 mL after salbutamol. FeNO is 49 ppb and blood eosinophils are 0.42 x 10^9/L. What is the most likely diagnosis?

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Correct answer: C — Asthma

Variable airflow obstruction with a significant bronchodilator response and type 2 inflammatory markers supports asthma. COPD is unlikely at this age without relevant exposure and with marked reversibility. Bronchiectasis and heart failure can cause cough or wheeze but are not the best fit for these objective tests.

Reference: BTS/NICE/SIGN Asthma Guideline 2024