02-21-2008, 01:41 PM
A 45-year-old man is evaluated because of a persistent cough. He is a lifelong nonsmoker without a history of lung disease. He has had a cough productive of clear sputum for approximately 6 months. The cough is particularly troublesome at night and toward the end of the workweek. The patient works in an automobile repair shop spray-painting cars. He has worked in his present job for 2 years. He denies a history of allergies, and there is no family history of asthma or allergies. The chest examination shows a few expiratory wheezes. Spirometry shows moderate airflow obstruction and substantial improvement after inhalation of a bronchodilator.
Which of the following is the best management option for this patient?
( A ) Measure carbon monoxide diffusing capacity
( B ) Advise him to change jobs
( C ) Prescribe an inhaled bronchodilator
( D ) Measure IgE antibody to anhydrides
Which of the following is the best management option for this patient?
( A ) Measure carbon monoxide diffusing capacity
( B ) Advise him to change jobs
( C ) Prescribe an inhaled bronchodilator
( D ) Measure IgE antibody to anhydrides