35 yrs old male with this type of Nails He is under treatment for Loss of appetite, weakness, fever, cough with expectoration & dyspnea ,H/O alcoholism His blood reports as follows Hb 8gm , TLC, 4600, ESR 15 XRC & USG Abdomen reports awaited Please explain DX & RX management thanks

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D.D 1) Lung disease- lung cancer, COPD, Interstitial lung disease, TB. 2) Heart disease- Chr. hypoxia, C.C.H.D. 3) G.T/Hepatomegaly biliary- Malabsorption, Crohn's disease, Ulcerative Colitis.
Drum stick clubbing..........Do CXR and ct of chest to rule out malignancy and bronchiactasis.......also do abbronchiscopic exam...............do an lft for cirrhosis...
Clubbing Kindly look up for CXR And USG abdomen It may be due to carcinoma or chronic lung disease Rx symptomatic management and specific management after reports .
Clubbing - feature of chronic hypoxemia. R/O hepatopulmonary/portopulmonary syndrome, chest TB, carcinoma. NOT COPD. COPD pt rarely have clubbing.
Diagnosis Clubbing Rule out Tuberculosis Ca lung COPD Ulcerative colitis Congenital heart disease
COPD,& TB Is never a cause of clubbing & cogenital cynotic heart is a cause of clubbing. In fact if you get clubbing in a known case of PTB think of post tubercular bronchiacstasis/ lung abscess/ empyema.
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Clubbing of nails, with cynosis , adv x-ray ,ECG 2d echo.
Clubbing.. May be d. T. COPDPulmonary kochs or ca lung
All the clinical features are in favour of TB .
Clubbing-causes:toxin,malignancy or hypoxia
Clubbing Cause waiting to be diagnosed.
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