By Rajeez; Wadhera, Monal; Bovill, Inaki; Beck, Eric Gulati
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5. 6. The pleural fluid LDH is > two-thirds of the normal level of plasma LDH. Pneumonectomy and lobectomy Describe your clinical findings Pneumonectomy On examination, this patient is comfortable at rest. There is a thoracotomy scar on the left chest wall, which is flattened. The trachea and apex beat are deviated to the left side. Chest expansion is reduced on the left (affected) side and the percussion note is dull. On auscultation of the chest, the breath sounds are reduced. These findings suggest a left-sided pneumonectomy.
There are no cutaneous features of liver disease initially owing to the rapid onset of liver failure. The liver is smoothly enlarged and tender. indb 40 2/27/13 7:28 PM ●● ●● ●● ●● ●● Hypercoagulable states: ●●pregnancy ●●contraceptive pill ●●PRV ●●essential thrombocythaemia ●●antiphospholipid syndrome ●●protein C, protein S or antithrombin III deficiency Hepatocellular carcinoma Hepatic infections such as hydatid disease Renal and adrenal tumours Congenital venous webs How do you investigate such patients?
There is widespread expiratory wheeze. These findings suggest a diagnosis of COPD due to cigarette smoking. What is COPD? ●● ●● ●● COPD is a term encompassing the spectrum of disease from chronic bronchitis to emphysema. It is a chronic, progressive disease. Chronic bronchitis is a clinical diagnosis. It is defined as a cough productive of sputum on most days for more than 3 months of 2 consecutive years in the absence of other diseases causing sputum production. Emphysema is a pathological diagnosis.