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    Medical students only

    THis is an x-ray froma patient of mine today. Incidental finding pre-operatively that led me to get a chest x-ray.
    Have a look at this X-ray and describe what you see and give a diagnosis.
    Tell me what I might have found on exam and int he history that led me to this.


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    Big gap so no one can see answers accidentally.
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    Larger patchy opacities - calcified pleural plaques? And maybe some diffuse reticulonodular shadowing. Fine inspiratory creps on examination? History of asbestos exposure?
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    There seems to be evidence of hilar congestion in the right lung and fibrosis(?) in the left lung. The widespread pattern of lesions in both lungs could possibly indicate miliary tuberculosis? Findings of enlarged lymph nodes on examination and the presence of crepitations on auscultation. History - homeless, AIDS?
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    (Original post by Huw Davies)
    Larger patchy opacities - calcified pleural plaques? And maybe some diffuse reticulonodular shadowing. Fine inspiratory creps on examination? History of asbestos exposure?
    Top notch. Give that man a gold star.

    The diaphramatic pleural calcification is always a big give away.

    Just thought it was a really good example of the x-ray for this condition really.

    And his previous profession was engineer working on heating/cooling pipes (asbestos++)
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    Would have said evidence of peri-hilar shadowing with multiple diffuse opacities. Differential, pneumonia, mets, First thought tbh was Wegeners - peri-hilar shadowing is classic, but then it is pretty rare...diagnosis is via ANCA.
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    (Original post by Wangers)
    First thought tbh was Wegeners - peri-hilar shadowing is classic, but then it is pretty rare...diagnosis is via ANCA.
    Thats so 1990. New more accurate test for Wegners. ANCA-PR3.
    AS opposed to ANCA-MPO
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    *feels smug even though I wasn't allowed to answer the question* :proud:
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    *feels apathetic*

    Home.
    Advised see GP.
    Link Letter sent.
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    It's not lupus. :smug:
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    (Original post by Renal)
    *feels apathetic*

    Home.
    Advised see GP.
    Link Letter sent.
    Your posts sometimes make me cringe. Please tell me you take more joy in your work @ work.
    [rather than that crushing tiredness that hits when you get home and work deemed evil personified]

    Last thing the specialty needs is another triage monkey...
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    (Original post by Jamie)
    Your posts sometimes make me cringe. Please tell me you take more joy in your work @ work.
    [rather than that crushing tiredness that hits when you get home and work deemed evil personified]

    Last thing the specialty needs is another triage monkey...
    I take a surprising amount of pleasure in my work. But, I also take a great sense of frustration in the aspects of the job that make me a triage monkey - the minors slog, the complicated and dying but well-enough patient who gets turfed to GP, the multitude of slightly unwell elderly ladies who have to come in 'to be safe'.
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    (Original post by Jamie)
    Medical students only

    THis is an x-ray froma patient of mine today. Incidental finding pre-operatively that led me to get a chest x-ray.
    Have a look at this X-ray and describe what you see and give a diagnosis.
    Tell me what I might have found on exam and int he history that led me to this.

    Fcuk me, I thought they had aspirated a toy axe. Go BARTS!
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    (Original post by digitalis)
    Fcuk me, I thought they had swallowed a toy axe. Go BARTS!
    and a seahorse...
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    Is the aortic notch always that big? :confused:
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    (Original post by Jamie)
    Thats so 1990. New more accurate test for Wegners. ANCA-PR3.
    AS opposed to ANCA-MPO
    You don't subscribe to the thought that we should renounce the eponymous title and rename it ANCA positive vasculitis as Mr Wegener was a Nazi then.
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    (Original post by Ataloss)
    You don't subscribe to the thought that we should renounce the eponymous title and rename it ANCA positive vasculitis as Mr Wegener was a Nazi then.
    I'm a great believer that someone eponymising a sign/disease is a bit of a penis regardless.
    I think the greatest retort is to forget who the actual person is that lent their name to it.
    (exception made for one disease/sign is named after the patient it was first described in)

    I strive for this level of enlightedness...
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    (Original post by Jamie)
    I'm a great believer that someone eponymising a sign/disease is a bit of a penis regardless.
    Are you referring to the originator of the John Thomas sign?
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    *1st year student enters thread optimistically*

    *reads*

    *summary of observations = :broken: and subsequently :ahee: *

    *leaves thread decides career in health & social care maybe more appropriate*
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    (Original post by JordanCarroll)
    *1st medical student enters thread optimistically*

    *reads*

    *summary of observations = :broken: and subsequently :ahee: *

    *leaves thread decides career in health & social care maybe more appropriate*
    Exactly this :rofl:
    • Thread Starter
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    (Original post by JordanCarroll)
    *1st year student enters thread optimistically*

    *reads*

    *summary of observations = :broken: and subsequently :ahee: *

    *leaves thread decides career in health & social care maybe more appropriate*
    Don't sweat it.

    Year on year more and more stuff will drop into place until finally you understand how it all connects up.
    Then !BAM! you know the very basics of the theory of medicine...
 
 
 
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