16th January 2024

A 45-year-old male presents with fatigue, unintentional weight loss and insidious onset shortness of breath.

A 45-year-old male presents with fatigue, unintentional weight loss and insidious onset shortness of breath. A chest x-ray reveals upper zone reticular interstitial changes. On examination there is digital clubbing and diffuse inspiratory crackles. He is a current smoker of 15 pack years and is a pigeon racer.  

Which of the following is the most appropriate next step in management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.