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Case base learning Respiratory Module CBL 3

Respiratory module CBL  3

A 24 years old married lady from a low socio economic class, presented with complaint of dry cough with occasional sputum and low grade fever for about 6 months. Fever usually occurs in evening with night sweats and remarkable weight loss.

On Examination: Thin, lean lady sitting on bed well oriented with time, place and person.

Vitals  

B.P                  :           90/60mmHg

Pulse                   :       110b/min, regular

Resp / R          :           26 breaths/ min

Temp               :           100° F

Anemia:++,   Jaundice: Nil, Edema: Nil, Clubbing: Nil, Lymph nodes: Not palpable

 

Chest Examination:

Inspection: Moving symmetrical with respiration. No recession seen

Percussion:      Resonant all over chest.Auscultation:  Decreased breath sounds

 

Lab Investigations:

 

Complete Blood Count-

Hb: 8 gm/dl,  MCV: 74 fL, TLC: 12,400/cumm,  Neutrophils: 45%, Lymphocytes: 55%,

 

ESR: 110mm/hour

 

Sputum for AFB:  Negative for 3 consecutive days.

 

Sputum Gene expert: Positive.

 

Liver FunctionsTest & Urea, Creatinine&Electrolytes:  with in normal limits

 

X-Ray Chest:  Diffuse miliary shadowing, No nodal involvement.

 

 

 

 

 

LEARNING OBJECTIVES

 

CBL 3

 

  1. Identify the patient having tuberculosis.

 

  1. Describe the pathophysiology of the given pathology.

 

  1. Interpret different types of tuberculosis.

 

  1. Define the management for the given scenario.