sn29 hassan alibrahim
TRANSCRIPT
TuberculosisHassan Alibrahim213121096SN: 29
Objectives:
Which two diseases do you consider that are most likely in this case?
Provide arguments in favour of each of the diagnoses that you consider
Which questions would like to ask him in order to differentiate between each of the diagnoses that you consider?
• A 48-year-old Caucasian homeless man, is brought to the emergency department. At admission patient appears ill.
• He has complaints of cough and yellow-green sputum with an occasional trace of blood .
• On physical examination : there is shortness of breath.
Case ..
Cont..• He is extremely tired for weeks. and has lost a lot of
weight during the past few weeks.
• The patient has a 40 pack-years smoking history. but has recently stopped smoking spontaneously.
• He has a constant pain near his right scapula which increases with moving.
• He sleeps poorly and has a night sweats.
“The differential diagnosis”
Based on the medical history
Weight loss
Cough
hemoptysis
Shortness of breath
These symptoms are common in
Lung cancer.
Tuberculosis.
Tuberculosis (TB) :
Tuberculosis (TB) is a bacterial infection spread through inhaling tiny droplets from the coughs of an infected person.
TB is caused by a bacterium called Mycobacterium tuberculosis.
The bacteria usually attack the lungs, but TB bacteria can attack any part of the body .
Symptoms and Signs of TB
Weight lossNo appetite
A bad cough that lasts 3 weeks or longer
ChillsFever
Cont..
Coughing up blood or sputum
Pain in the chestShortness of breath
Sweating at night
Homeless people are at increased risk of TB
Lung Cancer
Lung cancer is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung.
Causes of Lung Cancer
Smoking The incidence of lung cancer is strongly correlated
with cigarette smoking. About 90% of lung cancers arising as a result of
tobacco use. The risk of lung cancer increases with the number of
cigarettes smoked.
Symptoms of lung cancer
Which questions would like to ask him in order to differentiate between TB and lung cancer
Is there fever?
Is the weight loss is sudden or gradual?
Your exposure to smoke from other people's smoking
Your contact with certain chemicals, such as radioactive dust
What kind of work do you do?
Do you live in overcrowded areas ?
Are taking any medications ?
Do you have a personal or family history of respiratory problems and/or cancer?
Is there any other medical conditions ?
Are you contact with a person who has active TB?
Are you travel to places where TB is common?
Kumar & Clarks, Clinical Medicine , eighth edition (2012)..
The Merck manual nineteenth edition 2011.
MLB Bhatt, Surya Kant,Ravi Bhaskar. Pulmonary tuberculosis as differential diagnosis of lung cancer. South Asian J Cancer. 2012 Jul-Sep; 1(1): 36–42.
References