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USMLE 2CK Practice Question for November 27th

A 62-year-old refugee from Nepal is brought to the clinic by his daughter who is concerned about his cough. He arrived in the U.S. three weeks ago and is living with his daughter, who has been in the U.S. for a year. She has been concerned by how thin her father is, and while recently cleaning his room she found a blood-stained rag in the bed sheets. The patient states that he has smoked a pack per day for over 40 years. He reports that his cough has been present for over 2 years and is worsening, and that he also has been experiencing weight loss and night sweats. He denies any past medical problems. He reports no alcohol or intravenous drug use. He reports having had 2 wives in Nepal, both of whom have died, one in childbirth and the other from injuries related to an earthquake. His temperature is 37.2°C (99.0°F), pulse is 90/min, respirations are 22/min, blood pressure is 128/78 mm Hg, and oxygen saturation is 95% on room air. He appears cachectic. On pulmonary examination there are scattered inspiratory crackles and the expiratory component is mildly prolonged. Digital clubbing is noted on his fingers. As a single test, what is the most sensitive diagnostic test for this man's condition?

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