Breathlessness & non productive cough

Chief complaint A 58 y/o male came with the complaint of breathlessness and non productive cough for the past 2 months. Fever relieved with PCM but breathlessness continued even after antibiotics. History No history of any type of allergy. He has h/o surgery for hernia 5 years back. No other past surgical history. His family history includes lymphoma in father. He was a mild smoker but left it 5 years back. He works at a poultry farm and has pet pigeons at home. Vitals BP - 130/85 mmhg, HR - 110 bpm, Resp rate - 19 breaths/min, Temp - 98.2°F, O2 saturation - 94% on room air. Investigations Chest x ray was done which shows interstitial disease. Heart, abdominal examination was wnl. PF Tests: FVC - 2.58 (53%) FEV1 - 2.10 (56%) FEV1/FVC - 86 FEF - 2.56 PEF - 5.86 Management What do you advise for this patient?

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Pft suggest obstructive respiratory disease Sp02 is 94% Pt was smoker Xray chest suggest interestial disease This suggest pt is a c/o fibrosis lung disease with ILD Needs to keep on Antifibrotic drugs Steroids Bronchodilators 02 support by niv Duolin+budecort inhalation Consider antibiotics sos

Thanx dr Vedprakash Singh
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COPD Fibrosis Lung Disease Broad spectrum antibiotics Pulmocare cap Tab Medrol 8 MG BD in tapering order. Tab Mountair LC OD Tab Deriphyllin 300 BD Cap Pantaprazole OD. Inhalation butamide and levosolbutamol Syrp Cadiphylate 2 TSF TID Breathing exercises

I L D ( obstructive lung disease ) Antibiotics. Anti fibrotic. Steroids. Bronchodilator. Inhalation budecort +Duolin. Physiotherapy. Quit smoking and clean air breathing.

Thanks Dr Pushkar Bhomia
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58/M..Case of sub chronic bronchitis. tachycardia.moderately severe FEV D/D: COPD-extrinsic Allergic Alveolitis occupational lung disease. idiopathic pulmonary fibrosis Do ABG-HRCT Advise: -add bronchodilator therapy in nebulization form -Methylxanthines drugs to be added -antihistamine with LRA -systemic steroids to start. -steam inhalation -breathing exercises.

Thanks for ur appreciation Dr Md Altaf Hussain..
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PFT sugg of restrictive airways disease. Needs to see reversibility on bronchodilators response . Overall ILD. Adv HRCT. Also confirm the pattern. Antifibrotics if IPF ICS LABA combination if reversible response on PFT .

Advise for Covid profile and HDCT If no evidence of covid infection, confirmed Interstial lung disease with all tests and lung biopsy if possible Only then difinite treatment for ILD should be instituted with prognosis explained.

? ILD .. PFT .. NEED'S .. CLINICOPATHOLOGICAL EVALUATION WITH .. HRCT THORAX .. RT..PCR..COVID-19 .. PULMONOLOGIST OPINION ..

Tnx Dr Ashok Leel sir
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COPD Seroflo and Duoline rotacap inhalation sos through rotahaler Cap Acebrophylline 100 mg bd Ad 2 DEcho for cardiac studies Spirometery

Hrct Treatment from chest specialist R/0 sarscov2 Interstitial lung disease

I do agree with Dr Mansukh Rule out tuberculosis also -if proton pump inhibìtor is indicated better to use Lansoprazole consult pulmonologist

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