64 year old male with complaints of episodic sweating for the last 4 months.Occasional dry cough.No ho fever or weight loss.Non-smoker.Hb 14,wc 14400,esr 35,FBS 114,T3T4TSH normal.

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X ray shows bilateral hilar prominency lymph node enlargement and rt basal consolidation? or pleural pathology? WBC count is increased . Do sputum culture and for AFB. Do ESR. Do glycosylated HB to rule out diabetes. Do Liver function test to rule out liver patholgy giving rise to pulmonary symptoms. Start broad spectrum antibiotics for 7days and see the response.

Xray shows... 1.both hilar prominency 2.Rt Costophrenic angle opacity 3.Obliterated Rt Cardiophrenic angle 4.Little wide mediastinum Further investigations to be done : 1. CECT thorax (to exclude carcinoma, pleural thickening, pleural effusion) 2.Echocardiography (To exclude cardiomyopathy or enlarged heart Chambers)

pancoast tumour

HRCT Thorax for any mediastinal mass

copd with consolidation. .

LRTI...give antibiotic. do 2d echo to rule out RVF ...bilateral lower lobe hazzyiness may be pulmonery edema...ecg ...rule out everything

COPD with consolidation.

rt sided basal consolidation leading to shift trenches slightly on rt side,so may b fibrotic changes r started needs CECT for further management

Clinical picture and radiologic findings consistent with Rt basal consolidation. Peripheral Rt lung fields look hazy a diagnosis consistent with an atypical pneumonia.

COPD with consolidation

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