10th September 2020

A 70-year-old man presents to his GP with a 1-month history of a copious, productive, persistent cough

A 70-year-old man presents to his GP with a 1-month history of a copious, productive, persistent cough. He says his sputum resembles “runny phlegm” but has noticed streaks of blood yesterday. He has lost 6kg of weight in the last month but puts this down to loss of appetite. He has not been suffering from any headaches and has never smoked in his life. His past medical history includes hypertension, for which he is on ramipril. On examination, you note digital clubbing, spoon-shaped nails and painful wrist, knee and ankle joints. Respiratory examination is insignificant. Chest x-ray shows a peripheral nodule in the right upper zone.

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