67yr / F, presented with low grade fever, chest pain, DOE, coughing out small 'stick like substance' off and on. CXR, ECG, Echo attached. Sputum AFB is negative, She is stage 1 hypertensive and non Diabetic.

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Xraychest shows prominent bronchovascular markingssuggestive of copd coughing out small sticky substance is shading of bronchial epthelium. Her ecg on face of it looks normal except mild changes of Lvh due to hypertension.overall i will treat her copd with chest inf with antibiotic like Amoxyclav +tab pulmoclear +pulmclear syp and foracort rotahalers 200ug twice daily.

Yes agree with U
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Bronchiactetic changes present at right lower lung.

Thanks sir.
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First u do ABG & Routin lab, cardiac marker, HRCT X ray shows copd. Ecg T wave inversion in ant. Leads. May i advise start inj. Solumedrol 40 mg. Od, inj. Aminophylline infusion, Inj. Lasix 40 mg stst & 8 hrly.nebulise pt. With flohel foracort 8 hrly & Tab Abflow 200 od. Broncho dialeter with mucolyte give. Control bp with antihyper tensive. If cardiac marker is positive then add antiplates. Station.

Patient is having low grade fever ,DOE for evolution x ray and ECG are given to u At all there is no emergency to jump, put your differential diagnosis and think accordingly With the history it looks respiratory case X ray is suggestive of rt bronchiectasis probably active or sequale of old infection, try to isolate the organism by doing sputum culture and treat accordingly and prevent recurrences by measures like prophylaxis and physiotherapy. Do a PFT and decide PROGRESSION of disease and accordingly prescribe bronchodilator About cardiac biomarkers, I don't know how it is going to helpful here in non significant ECG and echo Aminophylline is being used in statu asthmaticas, in these days no more in use because of better availability of options and more of cardiotoxic
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LVH by sokolov criteria however Echo is normal.... Xray chest is showing b/l ground glassing in lower zones with fibroreticular opacities... I would suggest an HRCT for her

Her scan chest Bilateral basal reticuoonodular shadows s/o iLD pic Fever may be due to sec inf

bilateral emphysematous lung fields ; long standing asthma or copd

This lady has a chest infection and mild lvh due to not treated hypertension treat chest infection with antibiotics like Amoxicillin 250 MGM TDs. Use asthalin Tab 2mg TDs ,I don't believe in cough syrups and treat hypertension with choice of anti hypertensive may be atenolol 50 mg daily and manage till controlled.

LVH, IHD, LVDD, PH with pulmonary oedema and Secondary infection.

Bronchiectatic changes in right lower zone. Needs HRCT scan thorax for clarification. May be tubercular sequelae also.

LVH/ inf lateral wall ischemia:echo normal Emphysema, bronchiectasis changes Rt mz/Lz/ Left mz Lz. Nebulisation, antibiotics if leucocytosis is present. CT chest advisable

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