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Progressive dry cough and clubbing over a year — ILD; HRCT shows honeycombing. Interstitial lung disease (interstitial fibrosis — dry cough, exertional dyspnea, fine crackles, clubbing; HRCT — honeycombing/ground-glass; PFT — restrictive — low volumes, low DLCO): IPF (idiopathic — pirfenidone/nintedanib slow decline; oxygen, transplant) vs secondary (connective tissue, hypersensitivity — avoid antigen + steroids, occupational). Lung cancer (smoking — persistent cough, hemoptysis, weight loss; small-cell — aggressive, chemo-responsive; non-small — surgery if localized, targeted/immunotherapy by mutation). Respiratory failure (type 1 — hypoxia, normal CO2 — pneumonia/ARDS; type 2 — hypercapnia — COPD exacerbation; ABG decides; NIV for type 2). The dry progressive cough is interstitial — image it.