Correct!
5. All of the above

The patient’s COVID-19 was negative and his chest x-ray does not show any focal areas on consolidation. He is stable and could be transferred to the floor. His present therapy could probably be stopped but that is not one of the options.
It is important to recognize that this patient does not likely have COPD from cigarette smoking. Some assume that all shortness of breath is either heart failure or COPD probably since those are the two most common diagnosis. COPD would be unusual in this age group unless the patient has alpha-1 antitrypsin deficiency (A1AT). For reasons that are not entirely clear, patients with A1AT often present with reversible airway obstruction and can be misdiagnosed with asthma.
He is transferred to the floor and discharged on a short course of antibiotics, a rapid taper of his corticosteroids, and bronchodilators by metered dose inhaler. He is scheduled for follow up in the clinic in 10-14 days.

Which of the following should be done at his follow up appointment? (Click on the correct answer to be directed to the third of five pages)

  1. Repeat spirometry
  2. HRCT of thorax
  3. Review pathology
  4. 1 and 3
  5. All of the above

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