pt. 38.f c/o Dyspnea on exertion, cough with sputum, fatigue plz comments..



X-ray chest suggests obstructive airway disease with segmental collapse consolidation rt lower lobe.. Do a spirometry to assess /diagnose obstructive airway disease. Send sputum for AFB smear and bactec culture. Cect thorax. Bronchoscopy lavage and biopsy may be needed

send sputum for AFB,and geneexpert

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X-ray shows bilateral hyperlucent lung fields with bilateral hilar enlargement seems to be vascular cause maybe secondary to increased pulmonary arterial pressure. there is bilateral flattening of diaphragm suggestive of hyperinflation. one can proceed for right lateral view chest X-ray to rule out right lower lobe collapse and high resolution CT Thorax would be required to evaluate for pulmonary parenchyma, to rule out c o p d like changes. if pft demonstrate significant obstruction and high resolution CT Thorax reveals emphysematous changes then at such a young age one should rule out Alpha 1 antitrypsin deficiency...... especially if the history of cough and dyspnea is long standing. so efficient would require right lateral chest X-ray,high resolution CT Thorax,pft and Echo. this is all what can be said on this x-ray.

left-sided lower zone opacity is secondary to superimposed breast shadow

Rotated film with Hyperinflation, Rt upper zone infiltrate and bilateral hilar opacity with calcification. Evaluate with Sputum AFB, PFT and CECT for Obstructive Airway Disease, PTB/its sequelae and sarcoidosis

PFT ,Heamogram ESR sputum test for AFB PPD Test Ig E 2D echo coin shape opacity ,calcification to assess the anemia very common cause of breathlessness & murmur in heart. P Koch's Asthma Cardiac asthma.

Hyperlucent lung-fields s/o obstruction lung disease also prominent bronchoalveolar markings (Lt>Rt). ECG, Echo Pulmonary function test and sputum examination should be done.

left lower lobe patchy consolidation with minimal pleural effusion Emphysematous changes in both lobes


So the patient have cough with sputum with breathlessness on exertion with X-Ray chest suggest collapse at rt lower zone with silhouette sign. In the lt lower zone there is white shadow most probably consolidation . There is rt hilar lymphnode.

Left lower lung consolidation, if it is a shadow of breast, it should be bilateral, left lung pleural effusion, right side hyperinflation. pleural tap,AFB, Radiologist can still elaborate the X-ray.

asthmatic bronchitis, do routine work out, routine lab, afb, ekg, correct anaemia n vit. n protein difficiency, treat as asthmatic bronchitis...

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