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DR Awadhesh kr sharma,SR DEPTT OF MEDICINE MLB MEDICAL COLLEGE JHANSI(UP) Two Case studies
TWO CASE STUDIES
CASE - I
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Past history –  no h/o DM, HTN & TB. Personnel history –   Patient is chronic bidi smoker for 48 years, he used to smoke 30 bidi per day. Smoking index  = 48 x 30 = 1440 i.e. > 300
General examination  – Built – Average PR – 82/min  BP- 110/80 mm of Hg  RR – 16 / min  Temp – afebrile  Pallar--- ++  Cyanosis – absent Clubbing – absent Icterus – absent Lymph node enlargement – absent  JVP – not raised
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INVESTIGATIONS
 
 
 
On the basis of above history, examination and investigations the presumptive diagnosis is------ Right middle and lower lobe consolidation with cavitation
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So we think in terms of lung malignancy, & go for HRCT which shows –
 
Then we done USG guided FNAC of the lesion which confirms it to be squamous cell carcinoma involving rt middle & lower lobe of lung.
 
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CASE – II
 
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Past history –  no h/o DM, HTN, TB Personnel history –  Non bidi smoker Family history –  not significant On Examination PR – 100/min, regular, normovolumic, normal in character without any radiofemoral and radioradial delay. BP – 90/60 mmHg in right arm in supine position. RR – 22/min, regular, thoracoabdominal  Temp – N SpO2 – 86% without O2 Pallar-absent Cyanosis-absent Clubbing-absent Icterus-absent Lymphadenopathy-absent JVP – raised, cv wave present  Pedal edema--- +
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So, final diagnosis is pulmonary hypertension associated with lung disease and or hypoxemia cause COAD.
 

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CASE STUDIES

  • 1. DR Awadhesh kr sharma,SR DEPTT OF MEDICINE MLB MEDICAL COLLEGE JHANSI(UP) Two Case studies
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  • 6. Past history – no h/o DM, HTN & TB. Personnel history – Patient is chronic bidi smoker for 48 years, he used to smoke 30 bidi per day. Smoking index = 48 x 30 = 1440 i.e. > 300
  • 7. General examination – Built – Average PR – 82/min BP- 110/80 mm of Hg RR – 16 / min Temp – afebrile Pallar--- ++ Cyanosis – absent Clubbing – absent Icterus – absent Lymph node enlargement – absent JVP – not raised
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  • 13. On the basis of above history, examination and investigations the presumptive diagnosis is------ Right middle and lower lobe consolidation with cavitation
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  • 17. So we think in terms of lung malignancy, & go for HRCT which shows –
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  • 19. Then we done USG guided FNAC of the lesion which confirms it to be squamous cell carcinoma involving rt middle & lower lobe of lung.
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  • 29. Past history – no h/o DM, HTN, TB Personnel history – Non bidi smoker Family history – not significant On Examination PR – 100/min, regular, normovolumic, normal in character without any radiofemoral and radioradial delay. BP – 90/60 mmHg in right arm in supine position. RR – 22/min, regular, thoracoabdominal Temp – N SpO2 – 86% without O2 Pallar-absent Cyanosis-absent Clubbing-absent Icterus-absent Lymphadenopathy-absent JVP – raised, cv wave present Pedal edema--- +
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  • 37.  
  • 38. So, final diagnosis is pulmonary hypertension associated with lung disease and or hypoxemia cause COAD.
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