Which clinical definition establishes a diagnosis of chronic bronchitis?
- A Productive cough for at least 6 months in the preceding year
- B Post-bronchodilator FEV1/FVC ratio below 0.70 with dyspnea
- C Productive cough on most days for at least 3 months in each of 2 consecutive years ✓
- D Chronic cough with sputum plus evidence of emphysema on HRCT
Correct answer: C. Productive cough on most days for at least 3 months in each of 2 consecutive years
Explanation
Chronic bronchitis is defined clinically as cough productive of sputum on most days for at least three months of the year, occurring in two consecutive years, after other causes of chronic cough have been excluded. It is a clinical syndrome distinct from airflow limitation, so spirometric obstruction and radiographic emphysema define COPD and emphysema respectively, not chronic bronchitis.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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