Patient History: A 62-year-old man is brought to the clinic for a 3-month history of unintentional weight loss (12 lb). His appetite has diminished, but he reports no vomiting or diarrhea. He does report some depressive symptoms since the death of his wife a year ago. He denies a smoking history. He complains of a 3-month history of a productive cough with greenish sputum. He has not felt feverish.
He takes no medications regularly. Physical Examination: His temperature is 100.4°F and respiratory rate 16 breaths per minute. His neck has a normal thyroid gland and no cervical or supraclavicular lymphadenopathy. His chest has few scattered rales in the left mid-lung fields and a faint expiratory wheeze on the right. His heart rhythm is regular with no gallops or murmurs. His abdominal examination is benign, his rectal examination shows no masses, and his stool is negative for occult…
