Concluded Case

55 lady presented with cough dyspnea anorexia since last 10 days. on some antidepressants, details not yet available. paller icterus present. RS left sided breath sounds reduced. h/o previous respiratory infection but not able to detail. Rv Hbs ag neg. sr creat is normal. sample sent for further work up. plz comment on her CT thorax and cbc.

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Concluded answer

Left sided pleural thickening, fibrosis, non homogenous cavitary lesion( destroyed lung?) Severe .,?? Hemolytic anemia( spleenomegaly present, cholilithiasis??

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Left lung collapsed and mediastinum shifted to left side It is likely to be a chronic disease, most likely tuberculosis, Please check h/o ATT in past, history of Asthama, COPD, history suggestive of bronchiectasis She has Normocytic Anemia , MCV is normal which suggest failure of hematopoiesis She has pancytopenia and deranged liver function test following causes need to be ruled out, 1) Chronic liver disease with cirrhosis, pancytopenia and liver failure 2) Acute viral hepatitis 3) Malaria 4) Aplastic Anemia 5) Myelodisplastic syndrome 6) Systemic lupus erythematosus 7) Sepsis with multiorgan dysfunction

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The patient has direct hyperbilirubinemia..rule out surgical causes of obstructive jaundice..live problem with acute pancytopenia could be drug-induced...one should send hepatitis A ,c, D and E also..blood transfusion and supportive treatment required..stop all antipsychotic medications CT picture is more chronic in nature..left destroyed lung with chronic effusion..compensatory emphysema of right lung..

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

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What's the report of sgpt& ot & PBS report RBC morphology CT shows destroyed left lung & compensatory emphysema on rt side.one of the possibility is mylopthisic anaemia for which bone marrow exam should be done.

Currently patient is refered to hematologist. Shall update ,once receive reports.
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It lungs destroyed due to extensive fibrosis as result of TB likely,drug induced pancytopenia LFT and usg abdomen for liver disease Drug history hiv status should be taken...

Thanks sir, hiv neg. Work up is awaited. On Antipsychotic drugs since 5 yrs.
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Left lung collapse with volume loss Severe anemia with raised bilurubin Drug induced pancytopenia Get Usg abdomen for liver pathology Whole blood transfusion needed Hepamerz 10ml IV with Ns 500ml Multivitamins Antibiotics

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Collapse left lung with loss of volume. Trachea and mediastinum shifted to left. Hyperinflation of right lung.

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Left sided pleural thickening, fibrosis, non homogenous cavitary lesion( destroyed lung?) Severe .,?? Hemolytic anemia( spleenomegaly present, cholilithiasis??

X-ray chest vanishing heart syndrome CT fibrocavitatory changes tubercular

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Drug induced anti tubercular drugs hepatitis should be ruled out whether the patient taking

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