A 60-year-old female presents with persistent cough, shortness of breath, and fatigue. She quit smoking ten years ago but smoked a pack a day for 30 years. She has also been experiencing hot flashes and night sweats for the last year. Her vital signs are within normal limits. What is your approach?
Given her smoking history, the symptoms of persistent cough, shortness of breath, and fatigue are concerning for possible chronic obstructive pulmonary disease (COPD) or lung cancer. The hot flashes and night sweats might be related to menopause, but it's important to rule out systemic conditions such as lymphoma or tuberculosis. The next steps would be to order a chest X-ray or possibly a CT scan to evaluate her lungs, as well as pulmonary function tests to assess for COPD. Blood tests, including complete blood count and metabolic panel, could provide additional information. If the night sweats and hot flashes are determined to be menopausal, they could be managed separately.