Progressive Dyspnea

A female who is a k/c/o Rheumatoid Arthritis since 5 years Chief Complaints Progressive Dyspnea Occ Cough Wheezing at night (occasionally) Physical Examination Clubbing (+) Resp - b/l crackles (+)

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Gr4th clubbing+ Kco RA Hrct shows bilateral fibrosis Possibly autoimmune ILD Crakles suggest basal congestion Pt is likely in CORPULMONALE STATUS Sp02 should be monitored Since being rheumatoid pt may be on steroids so review the total line of RA Add diuretics Tab pulmoclear Bronchodilators Duolin+budecort inhalation

Thanx dr Md Altaf Hussain
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Clubbing of figures typically occur as the result of chronic gastrointestinal conditions or conditions that interfere with circulating oxygen levels... Finger clubbing may be caused by respiratory diseases including: Bronchiectasis (destruction and widening of the large airways) Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis. Cystic fibrosis (thick mucus in the lungs and respiratory tract). Treatment of the underlying pathological condition may decrease the clubbing or, potentially, reverse it if performed early enough. Once substantial chronic tissue changes, including increased collagen deposition, have occurred, reversal is unlikely.

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D/D Cynotic heart disease Chronic lung disease Cirrhosis of liver Further evaluation is required for diagnosis and treatment

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

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Clubbing no bronchectesis ? CYONOTIC HEART DISEASE

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Tree in bud Rt pneumonitis Clubbing Pft R/0 pulmonary fibrosis

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BRONCHITIS? KOCH'S WITH SPUTUM? CHEST THORAX . DYSFUNCTION IN BLOOD PURIFICATION? INVESTIGATION FOR, CXR , CT OF CHEST HRCT, CBC, BIOCHEMISTRY , SYMPTOMATIC MEDICATION GIVE, REFER TO PULMONOLOGIST OPINION

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? ILD .. ? BRONCHIECTASIS .. ? KOCH'S ..

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This being a ostructive and irreversible process the lung tissue which got destroyed causes the shortness of breath.It is a kapha vataja disease.We should stress on the improvement of the healthy lung tissues activity.Nasya karma,application of cocconut oil mixed with camphor followed by sweda karma will help for free breathing.Talisadi churnam with ras sindoor,abhrak bhasma,sringi bhasma,kanakasava,sukumara ghritam for mridu virechana,swas kasa chintamani/mahalakshmivilas ras,soorya prabha gulika etc will help to lead him peaceful life to some extent.Mild breathing exercises should be adviced. Avoid vata kapha vriddikara ahar vihar.

RA with clubbing hand fingers: ? May be COPD? RA factor, RT-PCR test Blood sugar, CBC,ESR,CRP Sputum AFB

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