A 27-year-old female presents with a history of chronic
cough. It is a dry cough that occurs mainly at night and is also related to
exertion coming on when she goes jogging
There is no fever, no history of headaches, stuffy nose
or postnasal drip. Review of systems does not elicit any further symptoms. She
gives a history of bronchitis as a child. Her brother has eczema.
She does not smoke or drink and is not taking any
She works as a secretary in a legal firm. She is
On examination no abnormalities are detected. Routine
haematology and biochemistry are within normal limits.
Lung function tests show:
FEV1 4.0 (3.6-4.2 predicted)
FVC 5.2 (4.5-5.4 predicted)
PEFR 470 (440-540)
In this patient which of the
following tests would you arrange to ascertain the diagnosis?
b) CT scan of