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General Medicine General ec7264cf

A 33-year-old farmer complains of recurrent episodes of wheezing after working in a barn where hay is stored. On auscultation, there are bibasilar crackles and heart sounds are normal. His laboratory work is normal with no increase in eosinophils and the chest x-ray (CXR) reveals patchy lower lobe infiltrates. Which of the following is the most likely diagnosis?

A
asthma
B
chronic obstructive lung disease
C
hypersensitivity pneumonitis
D
bronchiectasis

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