A 20-Year-Old Man Comes to the Physician for Episodic Shortness

A 20-year-old man comes to the physician for episodic shortness of breath and a nonproductive cough for 3 months. These episodes frequently occur before sleeping, and he occasionally wakes up because of difficulty breathing. He also reports that he became short of breath during outdoor exercise. Physical examination shows no abnormalities. An x-ray of the chest shows no abnormalities. Spirometry shows a FEV1 of 72% of predicted. Sputum analysis shows predominant eosinophils. Exposure to which of the following is most closely associated with this patient's symptoms?

A) Acetaminophen
B) Gliadin-containing grains
C) Histoplasma microconidia
D) House dust mites
E) Shellfish and other seafood
F) Thermophilic actinomycetes

Correct Answer:

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