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HardRespiratoryAsthma-COPD overlapau-racpau-amc

A 55-year-old woman presents with exertional dyspnoea and episodic wheeze. She has a 40-pack-year smoking history and chronic cough. Spirometry shows FEV1/FVC ratio 0.68 with significant reversibility (15% and 250 mL) after bronchodilator. What is the MOST likely diagnosis?

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