Respond to Mr. Barley is a 58 year old farmer presenting to the clinic with increased shortness of breath and coughing worsening each day. He has been a smoker for the past 26 years but has tried to cut back recently. He has been concerned with the white phlegm he has been coughing up for the past 2 weeks, which has recurred over the last 2 winters. He does get short of breath when climbing the stairs or fast walking. He otherwise denies any fever, chest pain, epigastric pain, symptoms of CHF, recent travel, TB exposures and chemical exposures without PPE. He has been diagnosed with acute illnesses in the past, but never a chronic one. Family history is negative .
• Describe the physical exam and diagnostic tools to be used for Mr. Barley. Are there any additional you would have liked to be included that were not?
• What plan of care will Mr. Barley be given at this visit, include drug therapy and treatments; what is the patient education and follow-up?
