15th September 2020

A 69-year-old retired accountant presents to his GP with a 2-month history of a persistent cough

A 69-year-old retired accountant presents to his GP with a 2-month history of a persistent cough, worsening dyspnoea, unintentional weight loss and 2 episodes of haemoptysis in the past week. He has been feeling off balance and has been waking up with a throbbing headache in the mornings. He has a past medical history of COPD, a smoking history of 1 pack a day for 45 years and still continues to smoke. Respiratory examination reveals reduced air entry and stony dull percussion in the right base. You order some blood tests which come back as normal except for mild hyponatraemia. 

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