WBR1151

Author	Vendhan Ramanujam
Exam Type	USMLE Step 2 CK
Main Category	Internal medicine
Sub Category	Respiratory
Prompt	A 53-year-old married African-American presents to the clinic with a complaint of persistent cough with mucoid sputum for the past 2 months. He denies any history of fever, malaise, or weight loss. He has a history of smoking half a pack of cigarette a day for the past 20 years, which he stopped before three years. He lives with his wife and exercises regularly three times a week. He has been working as an office manager in a mining industry for the past 20 years. He has a past medical history of three episodes of similar illness lasting for more than three months in the past two year and hypertension for the past five years, for which he is taking chlorthalidone daily. His vital signs are temperature 36.7 C, blood pressure 130/80 mmHg, pulse 86/minute, and respirations 14/minute. On physical examination, mild wheeze in both the lungs and pharyngeal erythema without exudates could be elicited. What is the most likely cause of this patient’s persistent cough?
Answer A	Pharyngitis
Answer A Explanation	Incorrect -
Answer B	Silicosis
Answer B Explanation	Incorrect -
Answer C	Mycoplasma pneumonia
Answer C Explanation	Incorrect -
Answer D	Chronic obstructive pulmonary disease
Answer D Explanation	Correct -
Answer E	Chronic heart failure
Answer E Explanation	Incorrect -
Right Answer	D
Explanation	Educational Objective: References:
Approved	Yes
Keyword	Chronic obstructive pulmonary disease, COPD
Linked Question
Order in Linked Questions