An old Asthma case on World Asthma Day

A 46-year-old female, was admitted for wheezing and dyspnea. She had been diagnosed with asthma 10 years previously and was well controlled using budesonide at 160 μg + formoterol at 4.5 μg b.i.d. combination therapy until 5 months before when she had a severe asthma attack at that time, during which her wheezing was not well correlated with physical exercise and had persisted for several months. She was treated unsuccessfully with budesonide at 320 μg + formoterol at 9 μg b.i.d. combination, montelukast at 10 mg/day, and oral steroids. Her medical history was significant for appendectomy and hemorrhoidectomy. She was taking thyroid hormone for Hashimoto's thyroiditis and calcium tablets for osteoporosis. What is your opinion on the case?

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Hyperinflated lungs Emphysematous bullae Lt lower zone suggest haziness with ?cavitory lesion Explore secondary chest infection like pneumonitis or tuberculosis

Thanx dr Kute Ankush
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COPD EMPHYSEMA Lt lung pneumonitis OR PTB Needs further investigation and evaluation to conclude and treatment plan.

Thanks Dr Kute Ankush
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Emphysematous changes Lt lung Lowe zone consolidation Sputum TB PCR is advised.

Copd Emphysema Lt lung pneumonitis R/O tuberculosis Ad CBNAAT Sputum exam

? PNEUMONITIS.. ? PTB.. NEED'S.. HEMOGRAM.. SPUTUM AFB.. CBNAAT ..

Tnx Dr Ashok Leel sir
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On which drug for Hashimoto & TFT results.

This is a 46 YEARS OLD FEMALE HAVING A LONG STANDING IND B ATHAMA FOR LAST 10 YEARS FROM THE HISTORY IT SEEMS SHE IHAS MOT RESPONDED WELL TO ANTIASTHAMA MEDECATION BESIDES SHE ALSO HAS HADHIMATOES THRIODITI S I FEEL HER APPENDECTOMY AND HEMORIODECTOMY MUST HAVE BEEN DONE UNDER SPINAL BECAUSE WITH HER PRESENT STATUS SHE WOULD NOT BE A FIT CASE GOR G A AS FAR AS HER B ASTHAMA STSTUS IS CONCERNED NEEDS PERIODIC LUNG FUNCTION TESTS OXYGEN SATURATION AND REGULAR CONSULTATION OF CHEST PHYSICIAN

CT of this patient shows emphysematous changes with left basal GGO,.indicating pneumonitis . Sputum for AFB and CBNATT. Antibiotics, salbutamol inhalers, ipratropium inhalers. Serial HRCTs

Consider asthma COPD overlap syndrome. In association with sec infection. May add LAMA to present regimen.

COPD emphasematoous changes with secondary infection ? Pneumonitis ? Kochs

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