kaplan Q.....

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kaplan Q.....

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drduck
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01/08/08 - 08:08 AM

A patient consults a physician because of chronic nasal congestion and nose bleeds over past 2 yrs. He has tried numerous over the counter medications, but nothing has helped.
He has also felt chronically ill, with low grade fevermalaise and anorexia. Nasal examination demonstrate a friable mucosa with a red, raised granular appearence that bleeds easily.
A small area of nasal septal perforation is seen. Chest X-ray film demonstrates pulmonary infiltrates with associated cavitation n one case.
Which of the following is the most appropriate next step in diagnosis?

A) Abdominal CT scan

B) Liver enzymes

C) Pancreatic enzymes

D) Urine analysis

E) Bladder biopsy.

neurom
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01/08/08 - 08:21 AM

D - Wegener's granulomatosis

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dr.wad
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01/08/08 - 08:44 AM

yes D wegeners

Ivonne
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01/08/08 - 08:58 AM

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jean robert
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01/08/08 - 09:16 AM

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multifactorial
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01/08/08 - 09:46 AM

urine analysis which migth show hematuria and proteinuria coz i think this is Wegener's.

anastamosis
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01/08/08 - 01:32 PM

what will be the finding in urinalysis

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Aashi
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01/08/08 - 02:30 PM

anastamosis wrote:
what will be the finding in urinalysis

Wegeners G------>Vasculitic Glomerulonephritis( Nephritic syndrome)------>So Urine analysis will show Hematuria, RBC casts and proteinuria

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drduck
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01/08/08 - 09:22 PM

everyones right, its wegeners gran.

i got this one wrong.......i thought of cystic fibrosis......
Q.....do patients of CF have nasal septal perforation??
what will be there x ray lung picture
help.

Aashi
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01/09/08 - 02:32 AM

#10

drduck wrote:

Q.....do patients of CF have nasal septal perforation??
what will be there x ray lung picture
help.

Xray findings in CF------->hyperinflation and peribronchial thickening and bronchiectasis mainly in the upper lobes

Sinus Xray---->shows Panopacification ------> present in almost all patients with CF, and its presence is strongly suggestive of diagnosis and absence of panopacification strongly rules out CF as a dx..

Nasal polyps and chronic sinusitis ------->can form mucopyocele, by eroding the sinus wall, Havent heard abt septal perforation in CF..

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