A 64 year old man complains of increasing SOB (shortness of breath)and cough for the past 18 months. He coughs up a table spoonful of mucopurulent sputum with occasional specks of blood. What is the most likely underlying cause?

The key is C. Chronic bronchitis. [There may be specks of blood in sputum in both bronchiectasis, acute and chronic bronchitis. Duration of disease is 18 months, so it is not acute bronchitis. Again only one tablespoonful sputum does not justify the term copious sputum of bronhiectasis in which sputum will be much more like cup-full in amount. So it is chronic bronchitis].