drduck
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A 55 yr old man presents with 2 day h/o hemoptysis. He reports an acute onset of 8 episodes of coughing bright red blood. He has coughed a teaspoon worth of bllod on average in each instance.
He reports no other symptoms, except for a cough producive of 5-10 ml of sputum each morning. He has a h/o COPD for which he takes bronchodilators. He has smoked 3 cigarettes daily for past 30 yrs.
Physical examination is normal, and an x-ray film is clear. Which of the is most likely cause of this man's hemoptysis?
A) Alpha1 antitrypsin deficiency
B) Broncheactesis
C) Bronchogenic caricinoma
D) Chronic bronchitis
E) Pulmonary tuberculosis
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| dr.wad
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D
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| neurom
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b
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| Ivonne
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B Need CT of chest for diagnosis
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| jean robert
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C
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| multifactorial
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C given the history
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| cool doctor
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C its acute
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| arlete
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D
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| bax
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D
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| anastamosis
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D
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| drduck
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some how i felt question to be a real easy but when i got it wrong i thought shud share it with u,
i went for bronc carcinoma, but answer was chronic bronchitis,
but still if someone gives good evidence for why it has to be cr, bronchitis not a carcinoma i wud be really thankful.
for all who think answer is CHRONIC BRONCHITIS, yes they are correct.
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| mildus
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Chronic bronchitis and completely normal lung sounds? I also thought it was carcinoma, given that he was a smoker, TB also can be a cause but I suppose it would be visible on CXR
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| cool doctor
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chronic bronchitis with normal PE!
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| drduck
Forum Guru
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bottleneck is that one shud not get too much emotional with the Q,
and few like these are a real teasers,
we first suspect a disorder like chr. bronchitis in this case....but there were some finding going away from it.....its time we think that thers something wrong in this Q.....
we give one more reading now stressing on points that deviate our diagnosis....it has to be something but not chr. bronchitis.
and this is the time we take a totally wrong track.....leading us ultimately to a wrong diagnosis and wrong answer.
frankly speaking we(even i) just cant get rid of this.....its too difficult...
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