Week 228 - Fungal Disease Flashcards
A 56 year old lorry driver presents to his GP with a six week history of abdominal discomfort. He has also noticed an unintended weight loss of 15 kilos. He has notice that he is short of breath on exertion and feels generally “under the weather”.
You see abundant small nodules scattered through the lung fields
Miliary Tuberculosis
A 62 year old woman presents with breathlessness, confusion, pyrexial and pleuritic pain on the left side. HR and RR increased. Reduced expansion on left side and dull to percussion. Left pleural rub is present as well as bronchial breathing. WCC and CRP are up.
The lower lobe appears expanded and solid yellow/brown without spongy airspaces. She is known to be a smoker.
This is a consolidated lung Obstructive pneumotitis (secondary to proximal airway obstruction by tumour/foreign body)
A 70 year old female presents with shortness of breath. She gives a history of having smoked 20 cigarettes/day for past 60 years. She regularly gets short of breath on exertion but recently been complaining of difficulty with her breathing at rest. On examination she has a hyper-expanded chest that is hyper-resonant on percussion.
COPD
A 51 year old pub landlord presents to his GP with 2 months history of cough, weight loss and shortness of breath. Recently he has noticed a small amount of blood on his handkerchief, from his sputum.
Lung cancer
A 65 year old man presents with gradually worsening shortness of breath. He is a non-smoker but had worked with asbestos on a daily basis during his early career as a roof insulator.
Mesothelioma
Asbestos exposure, especially straight fibres predispose to condition
What is the nerve supply to the pleural layers?
Parietal - intercostal, phrenic nerves, C3/4/5
Visceral - autonomics from the pulmonary plexus
Name some oncogenic viruses in patients with AIDS
Kaposi sarcoma - HHV-8
B cell Lymphoma - EBV
Cervical, anal carcinoma - HPV
