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Student Education

Interstitial lung disease and weight loss

BMJ 2005; 331 doi: https://doi.org/10.1136/sbmj.0509324 (Published 01 September 2005) Cite this as: BMJ 2005;331:0509324
  1. Sadat Edroos, final year medical student1,
  2. Laura Samuel, final year student1,
  3. P D J Handslip, consultant physician2
  1. 1Warwick Medical School
  2. 2George Eliot Hospital, Nuneaton

A 52 year old man presented to the outpatients' department with dyspnoea, dry cough, and weight loss. The breathlessness had progressed over two years. Also 41 kg of weight loss in 12 months was concerning.

In seeking a cause for this, he underwent bronchoscopy two weeks before his outpatients' appointment, and since then his breathlessness had rapidly worsened. At the consultation he was unable to complete a sentence and was in a wheelchair.

Questions

  1. What is the main abnormality shown in the figure? Suggest some causes.

  2. What would you expect to find on examination? What is the immediate management?

  3. What are the differentials for the chronic aspect of this presentation?

  4. What risk factors should be identified in the patient's social history?

  5. What would you do next? (6) What was the outcome?

Answers

Chest radiograph on admission

  1. There is an absence of lung markings in the left upper zone of the chest radiograph. The …

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