61 year?old man presents to OPD with complaints of persistent, non-productive cough for 1 month. He has no other symptom. He is smoking around 20 biddis per day for last 25 years. Physical examination is normal. What is the line of management in such patients?
Lung cancer Most common symptom in chronic smokers is persistent cough and chest X Ray is a must for such patients. Smoking cessation can reduce risk of lung cancer. Cessation at or before middle age can reduce the chances of lung cancer by 90% But in this case scenario, patients is elderly and will not have a strong will to achieve the goal of smoking abstinence. Therefore after doing a chest X ray, he must be referred to smoking cessation clinics so that compliance can be monitored and effective counselling can be done .
Reassurance and advise him to quit smoking
Prescribe oral antibiotics for 7 days
Do a chest X ray and refer him to smoking cessation clinic
Go for a CT thorax to visualise pathology
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