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COPD diagnosis — SCE Respiratory MCQ

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EasyCOPDCOPD diagnosisSCE Respiratory

A 70-year-old man with COPD has chronic cough and sputum. Post-bronchodilator spirometry shows FEV1 1.6 L (58% predicted), FVC 3.0 L (82% predicted) and FEV1/FVC 0.53. He asks whether he has asthma instead because symptoms vary. What is the most likely diagnosis?

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Correct answer: E — COPD supported by persistent post-bronchodilator airflow obstruction

Persistent post-bronchodilator airflow obstruction in a symptomatic older smoker supports COPD. Variability in symptoms can occur in COPD and does not by itself establish asthma. ILD, OHS and PE would not be diagnosed by this obstructive spirometric pattern.

Reference: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/