18y/o male c/o severe irritable dry cough continuously since 1week..no h/o of asthma,smoking,allergy.Vitals are spo2-93% a room air,bp 100/70,lungs clear,bae+ His investigation reports..kindly give me the relevant dDx, Rx and management further..



Hypoxia in young individual with normal looking x-ray can only be explained by (1) obstructive airway disease like Asthma Or (2) pulmonary embolism.. Incidently the upper zone Of the left lung shows sparse lung markings.. Perform a spirometry to exclude obstructive airway disease.. If normal.. Ct pulmonary angiography should be performed.. We can not ignore spo2 93% on room air...

ddx...postnasal drip syndrome or UPPER AIRWAY COUGH SYNDROME ( UACS ), GERD, laryngopharyngeal reflux, non allergic eosinophillic bronchitis ( NAEB ), etc...r/o upper respiratory tract disorders like allergic rhinitis/sinusitis,NAEB responds to steroids, gerd responds to acid suppression...may be a cough variant asthma..in cough variant asthma only prominent symptom is cough...

Hypoxia - normal CXR - asthma / copd - PE - spirometery/ CT angiogram/ d dimer for final diagnosis -

seems to be a case of obstructive lung disease. do spirometry to rule out asthma.If spirometry report is normal review the history properly because sometimes spirometry report may be normal in asthmatic PT. At the end you may advice CT CHEST to rule out any other pathology.

needs cbc esr mox cv broncho dilator levoceyriz with monteleu cough sedatives like code in syp

COPD with broncheictasis do hrct with expiratory films pft sputum for culture and sensitivity

rule out tropical pulmonary eosinophilia AEC pbs for filariasis.

COPD Emphysema DD pulm Embolism Go for HRCT CHEST, ECHO, ECG,

Is there urti with cough? Pharyngitis or laryngitis? If no ?Eosinophilia Dec for one mnth Anti alergic Steroid, Antibiotic Bronchodilators Symptomatic rx

Where is hypoxia complaining pt.

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