40-year-old Woman in Medicine / Internal Medicine — 40yo Woman | Respiratory / Pulmonology | SMLE Q#16642

SMLE Question #16642

Medicine / Internal Medicine Respiratory / Pulmonology

Objective: OBJ-123

Last updated: February 2026
A 40-year-old woman has recurrent episodes of shortness of breath, chest tightness, and dry cough triggered by house dust and strong perfumes. Symptoms are intermittent, worse at night, and improve when away from triggers. She has never smoked. Examination shows a mild expiratory wheeze. Baseline spirometry is normal. Which of the following additional tests has the highest diagnostic value to confirm the suspected diagnosis?

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