A 68-year-old man with lung cancer presents to the Emergency Department complaining of chest pain and shortness of breath. He reports no cough or sputum production. Upon auscultation, his chest is clear. His pulse is irregularly irregular and measures 110 bpm, while his oxygen saturation is 86% on room air. He is breathing at a rate of 26 breaths per minute. What diagnostic investigation is most likely to be effective in this scenario?
A 67-year-old woman presents with right-sided pleural effusion. Thoracentesis is performed and the pleural fluid analysis reveals the following results:
Pleural fluid Pleural fluid analysis Serum Normal value
Protein 2.5 g/dl 7.3 g/dl 6-7.8 g/dl
Lactate dehydrogenase (LDH) 145 IU/l 350 IU/l 100-250 IU/l
What is the probable diagnosis for this patient?
A 65-year-old man presents with haemoptysis over the last 2 days. He has had a productive cough for 7 years, which has gradually worsened. Over the last few winters, he has been particularly bad and required admission to hospital. Past medical history includes pulmonary tuberculosis (TB) at age 20. On examination, he is cyanotic and clubbed, and has florid crepitations in both lower zones.
What is the most likely diagnosis?
You are reviewing a patient who attends the clinic with a respiratory disorder.
Which of the following conditions would be suitable for long-term oxygen therapy (LTOT) for an elderly patient?
A 50-year-old man presents with a chronic cough and shortness of breath. He has recently developed a red/purple nodular rash on both shins. He has a history of mild asthma and continues to smoke ten cigarettes per day. On examination, he has mild wheezing and red/purple nodules on both shins. His blood pressure is 135/72 mmHg, and his pulse is 75/min and regular. The following investigations were performed: haemoglobin, white cell count, platelets, erythrocyte sedimentation rate, sodium, potassium, creatinine, and corrected calcium. His chest X-ray shows bilateral hilar lymphadenopathy. What is the most likely underlying diagnosis?
A 67-year-old man comes to the Chest Clinic after being referred by his GP for a chronic cough. He complains of a dry cough that has been ongoing for 10 months and is accompanied by increasing shortness of breath. Despite multiple rounds of antibiotics, he has not experienced significant improvement. He has never smoked and denies any coughing up of blood. He used to work as a teacher and has not been exposed to any environmental dust or chemicals.
His GP ordered a chest X-ray, which reveals reticular shadowing affecting both lung bases. Upon examination, he has clubbed fingers and fine-end inspiratory crackles. His heart sounds are normal, and he is saturating at 94% on room air with a regular heart rate of 80 bpm and regular respiratory rate of 20. There is no peripheral oedema.
What is the most probable diagnosis?
A 41-year-old man presents with wheezing and shortness of breath. He reports no history of smoking or drug use. An ultrasound reveals cirrhosis of the liver, and he is diagnosed with alpha-1-antitrypsin deficiency. He undergoes a liver transplant. What type of emphysema is he now at higher risk of developing?
A 32-year-old woman visits her General Practitioner seeking assistance to quit smoking. She has been smoking ten cigarettes daily for the last 14 years and has no significant medical history. However, she is currently in her second trimester of pregnancy. What is the most suitable first-line smoking cessation option for this patient?
A 35-year-old woman of Chinese descent is referred to a Respiratory Physician by her General Practitioner due to a productive cough with mucopurulent sputum and occasional blood tinges. She has also been experiencing shortness of breath lately. Her medical history shows that she had a similar episode of shortness of breath and productive cough a year ago, and had multiple bouts of pneumonia during childhood. What is the most reliable test to confirm the probable diagnosis for this patient?
A 32-year-old postal worker with asthma visits his GP for his annual asthma review. He reports experiencing breathlessness during his morning postal round for the past few months. Despite a normal examination, the GP advises him to conduct peak flow monitoring. The results show a best PEFR of 650 L/min and an average of 439 L/min, with a predicted PEFR of 660 L/min. What is the most likely interpretation of these PEFR results?