Reference no: EM133908902

Question

A 74-year-old man presents for SOB, cough, wheezing, and fatigue for 1 week. His SOB and cough have worsened in the past 3 days, prompting him to seek care at the clinic. He denies fever, sweating, or chills. The patient states that he has been getting "winded" when he walks to his mailbox (approximately 60 ft.). On further questioning, the patient admits to smoking one pack of cigarettes a day for the past 50 years and has no desire to quit. He states, "I will die soon anyway, why quit now?" On further review of his patient chart, it is noted that he has presented with the same chief complaint in the past and was diagnosed with acute bronchitis and treated with albuterol and antibiotics. He has not been to the office in over 3 years. What is the differential diagnosis? What is the most likely diagnosis? Why? Demonstrate your understanding about the pathophysiology in regard to the most likely diagnosis. Should tests/imaging studies be ordered? Which ones? Why? Think about tests/imaging beyond the primary care setting as well. What are the next appropriate steps in management? If you have decided to prescribe a medication, provide the drug name generic.