Diagnosis and management ?

56yrs old housewife, C/c of breathlessness × 1 month cough× 1 month Chest pain × 20 days Sweating × 20 days. Breathlessness on exertion since 1 month associated with cough which was yellow in colour,thick in concistency. History of HTN No history of DM Past history :- Pulmonary TB (treated) Vitals :- Well oriented to time ,place and person. BP:- 122/82 mmhg HR :- 100 bpm Weight :- 35kgs Temp :- 98.4°C

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Changes of COPD emphysema with bil bronchiectasis seen in upper lung fields. Hilum pulled up Tracheal deviation towards left. Sputum analysis including Gm Zn CBNAAT culture and sensitivity test. Echo CD to rule out PAH. Treat as COPD exacerbation including broad spectrum antibiotics bronchodilators mucolytics oxygen support steam inhalation chest physiotherapy etc.

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POSSIBLY FIBROSIS SECONDARY. TO P TB WITH SUPERADDED INFECTION NEEDS. FURTHUR EVALUATION

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Post TB Pul.fibrosis With sec. Bact.infection R/O reactivation TB Sputum for afb,gram stain,culture s, Antibiotics,bronchodilators,nebulisation,mucolytics,antipyretics

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Post TB Infection --- Pulmonary Fibrosis & Secondary Inf or Bacterial Inf Dx --- CBNAAT , AFB Test , Gram stain and Culture Rx---Bronchodilator, NSAIDs , Antibiotics & Cough Syrup

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