Concluded Case

80 ,yrs female presented with recurrent episodes of hemoptysis quantity around 100 to 150 ml. known COPD, no history of PTB in past. Hb 7.5 wbc 12600 plt 3.47 creat 1.4 RV neg. BSL 130 spo2 93% on room air and 97% on 2lit nasal o2. bil occasional crepts heard. comment on cxray.

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Concluded answer

Xray chest shows Rotation Trachea pulled to rt Crowding of ribs in upper zone b/l Scoliosis Hyperinflated lung fields Domes are pulled up Calcified bodies discreetly spread rt lung field Dense opacity rt paratracheal region H/o multiple episodes of hemoptysis Dropping of hb and 02 saturation With mild leucocytosis Suggest COPD WITH SECONDARY INFECTION and MALIGNANT LESION LIKELY CA

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Sir antibiotics Sputum afb cbnaat May be sec. Infection cause of copd exacerbation Ptb also need to rule out

Elderly ptCxr rotation +nt, COPD with emphysema & brochiolitis kyphoscoliosis. Bronchovascular prominent. Osteoporosis ribs ( & other bones). Need further evaluation,Rx& followup

Copd emphysema Pul. TB Hyperinflation Bilateral pneumonitis Scoliosis Scoliosis

HRCT, sputum examination, treat Hb.based on put antibiotic,anti TB drug.increse her resistance.

Xray chest shows Rotation Trachea pulled to rt Crowding of ribs in upper zone b/l Scoliosis Hyperinflated lung fields Domes are pulled up Calcified bodies discreetly spread rt lung field Dense opacity rt paratracheal region H/o multiple episodes of hemoptysis Dropping of hb and 02 saturation With mild leucocytosis Suggest COPD WITH SECONDARY INFECTION and MALIGNANT LESION LIKELY CA

Thanx dr Sabista Naaz
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SUGGESTIVE OF HYPERINFLATION SCOLIOSIS COPD EMPHYSEMA POSSIBLY PNEUMONITIS DD P. TB

Overexposed skiagram Scoliosis Hyperinflated lungs Copd,calcified pulmonary nodules r>l Better to have previous scan for comparison

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scoliosis.hyperinflated lung fields.copd/emphysema.reticulonodular infiltration especially in right mid zone.sputum examination and HRCT thorax.

Thank you doctor
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Sir cxr exposure is not good, still it looks like miliary TB.go for bronchoalveolar lavage,Reffer to anaesthesia for double barrel ET intubation to prevent aspiration in affected side

Thank you doctor
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Scilosis. Bilateral pneumonitis ?tubercular

Thank you doctor
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