Cough and uneasiness.

Chief Complaint A 71-year-old male with a history of gallbladder tumor presents with cough and uneasiness. History He has h/o obstructive sleep apnea He had finished his chemotherapy cycles 1 month back. Today he started complaining of cough, uneasiness and nausea. Investigations CT shows opacities in both lungs. Treatment Advise the management options.

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POSSIBLY METASTASES CLINICAL. CORRELATION

RTPCR for covid 19 Do blood counts, renal function tests, liver function tests

Lungs metastasis.. Oncologists opinion for further management.

for cough, Rx Zeel syrup 10ml bd Sanjivani vati 2bd Sudarshan ghanvati 2bd shunthi dhanyak fant for 3 to 4 days.

Evaluate for the active Infective species like, bacterial tubercular fungal infection. Sputum or BAL analysis.

Corticosteroid Antibiotic Ceftazidime 1mg slow IV Gentamicin injection IM Expectorants

First look for COVID, then opportunistic infections, then secondaries of gallbladder tumour.. Admit in ICU and in isolation I/v/o to avoid secondary nasocimial infection .. Investigations- CBC, RFT Start Broad spectrum antibiotics Imperical anti fungal medication like inj. Fluconazole 200mg OD nutritional supplementation Nebulization with SABA, Budecort O2 supplementation Dont start steroids unless its proven to be viral pneumonitis like covid 19 Can give HYDROCORT 100mg sos Take a chest physician opinion..

Metastasis. Symptomatic

? SECONDARIES IN LUNGS.. NEED'S.. SYMPTOMATIC T/T WITH CLINICAL CORRELATION .. ONCOLOGISTS OPINION.. CHEMOTHERAPY.. RADIOTHERAPY..

Tnx Dr Anil Gangani
1

Seroflo & Duoline rotacap inhalation through rotahaler s o s

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