Chest XR: Normal
Pulmonary Function Tests: Normal
Methacholine Challenge: Negative
24 Hr impedence study: Negative for laryngopharyngeal reflux and negative symptom index.
Laryngeal EMG: Increased recruitment in thyroarytenoid muscles during sniffing.
Laryngoscopy during exercise: Vocal cord dysfunction
Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.