A 70-year-old male, with a history of smoking presents with progressive dyspnea and dry cough. Examination reveals clubbing and fine basal crackles. Spirometry shows low forced vital capacity (FVC) and low diffusion capacity (DLCO). CT Chest shows extensive bilateral reticular shadows and subpleural honeycombing. What is the most likely diagnosis?
Idiopathic pulmonary fibrosis
Progressive dyspnea, dry cough, clubbing, fine bibasal crackles, a restrictive spirometry pattern (low FVC, low DLCO) and CT showing bilateral reticular shadows with subpleural honeycombing are the classic features of usual interstitial pneumonia pattern seen in Idiopathic Pulmonary Fibrosis. Sarcoidosis and COPD do not typically show honeycombing, and bronchiectasis shows a restrictive-obstructive picture with bronchial wall thickening rather than honeycombing.
A patient with a history of smoking presents to the emergency with a complaint of breathlessness for the last two days. On examination, he was found to be cyanosed and had bilateral rhonchi. ABG was done, which shows:
pH: 7.12
PaCO2: 80 mmHg
PaO2: 46 mmHg
HCO3-: 29 mEq/L
Based on the history, clinical examination and ABG finding, the most likely diagnosis is:
A patient with a history of chronic smoking presented with breathlessness for the last one year. On examination, there were bilateral rhonchi in the chest. The Chest X-ray was suggestive of hyper-inflated lung field. Which of the following parameters of the pulmonary function test are consistent with the diagnosis of chronic obstructive pulmonary disease in this case?
1. Decreased FEV1
2. Increased diffusion capacity
3. Increased residual volume
4. Decreased peak expiratory flow rate
Select the correct answer using the code given below:
A 40-year-old obese bank accountant presents with complaints of excessive daytime sleepiness and fatigue. His spouse reports that he has loud snoring and early morning tiredness. Which of the following statements is/are correct?
1. The patient is most likely suffering from obstructive sleep apnea.
2. The diagnosis requires CT/MRI of the neck.
3. Treatment of choice is Zolpidem.
Select the correct answer using the code given below: