10th September 2020

A 67-year-old man complains of exertional dyspnoea that has been worsening and a non-productive cough

A 67-year-old man complains of exertional dyspnoea that has been worsening and a non-productive cough over the past 2 months. His dyspnoea is not worse on lying down and he has not noticed any haemoptysis or weight loss. He has no joint pain, rashes or features of systemic inflammatory disease. He has never smoked and has no significant past medical history or family history. He is a retired bank manager and has had no environmental exposure that would explain his symptoms. Examination reveals digital clubbing and bi-basal fine end-inspiratory crepitations on auscultation. Spirometry reveals a FEV₁/FVC ratio of 82%.

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.