4th September 2020

A 65-year-old woman presents with a 14-month history of worsening shortness of breath on exertion

A 65-year-old woman presents with a 14-month history of worsening shortness of breath on exertion and a dry cough. She has not experienced any chest pain. She sees her GP regularly for type 2 diabetes, which is controlled with metformin. She has no previous cardiac history and has never smoked. Examination reveals fine inspiratory crackles over the lower lobes bilaterally. Spirometry shows a reduced FVC and a normal FEV₁/FVC ratio.

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