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Wednesday, November 16, 2016

A 68 Year Old Man, A Retired Fire Man Presents With Symptoms Of Lower Chest Infection

A 68-year-old man, a retired fireman, has developed symptoms of lower respiratory chest infection,
which have left him with a hacking cough. His CXR is shown below:



What would you arrange next to establish the diagnosis?
A A trial of inhaled corticosteroids
B Full lung function tests
C Fibreoptic bronchoscopy
D High-resolution CT chest scan
E Echocardiogram

Answer:
C  Fibreoptic bronchoscopy

Discussion: The CXR shows a rounded mass behind the heart that is highly suspicious of a lung cancer, bilateral calcified pleural plaques consistent with previous asbestos exposure, an enlarged heart and bilateral small pleural effusions. The risk of developing lung cancer amongst those who have been exposed to asbestos is significantly greater in smokers than in non-smokers.
The relative risk of lung cancer for cigarette smokers with a history of asbestos exposure is 59-fold,
compared with a 6-fold relative risk for non-smokers with a history of asbestos exposure. Cigarette
smoking without a history of asbestos exposure is associated with an 11-fold increase in the risk of lung cancer.

2 comments:


  1. I feel so excited today because it's just a year since I got my breakthrough from Herpes.I was diagnosed of HSV1 on the 12/4/2015 and latter i got affected with the HSV2. That was my 2nd outbreak after i lost my ex fiance that got me affected with the virus. I was so scared when he died and what i heard about the Herpes virus as he's deathly and such has no cure. I feel so pity and and a disgrace to my personality,in my career and my family to have been in with the deathly sickness, and that would makes my love ones siblings stay far from me. I was going to my regular church activities when i begin to hear testimonies of how people get cure online, i never gave it a thought till my cousin Stephanie who was affected with HIV told me, Lenny you need not to worry cos i met i man today online , i traditional herbal healer whom two of her friends confirmed he cure them with his herbal herbs that i should give it a try. I saw the interest in her and she did contact the herbal doctor again in my present, luckily for me he picked and show up himself, behold he was at about to attain to some patients that have came back with appreciation of how he cure them from Cancer, HIV, and off much too the herpes he cured an 18 years old daughter.
    I was so happy that day, i wanted to be there but the distance was a barrier to me. I told him how the virus had eaten me up and and a truly believe there's cure for herpes. He told me me with assurance that my case wont be different and he had been curing lots of people With his herbal medicine and most people due contact him from the States and preperd the medicine and made use of the DHL to reach him.
    Honestly speaking Dr. Akpu power his a great and gifted herbalist,His destined to herbs.
    He made me do away with the medical prescription,the acyclovir (Zovirax), famciclovir(Famvir), and valacyclovir (valtrex). you don't know him because you haven't meet this man try and contact him yourself Dr. Akpu in Africa is popularly known in his City,and you can request for his address yourself. I'm so happy now cos,I and my cousin had been confirmed negative till date..the Lord is good in my life. Dr. Akpu sent me his herbal medicine that heal me too, 🙏 🙏 Dr. Akpu for giving me another life.
    Contact Dr.akpu for all kids of sickness@
    Dr.akpupowerherbscenter@gmail.com

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  2. I was diagnosed of herpes virus, I have tried all possible means to get cure but all my effort proved abortive, until a friend of mine introduced me to a herbal doctor called Dr Agaba, who prepare herbal medicine to cure all kind of diseases including herpes virus (Herpes), when i contacted this herbal doctor via email, he sent me herpes virus herbal medicine via courier service, when i received the herbal medicine he gave me step by step instructions on how to apply it, when i applied it as instructed i was totally cured from the virus within 3 weeks of usage. Contact this great herbal doctor today to get your cure. 
    Via Email: Dragabasolutionhome@gmail.com or WhatApp: +2349074536486    

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