Examined I

Respiratory System


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M39_F1.jpg"}},{"insert":"\n\nYou and your colleague, Dr. J., have thus far spent the morning reviewing students. Right now, you are evaluating the case report of a fourth-year medical student by the name of Mr. Dunn.\n\n\u0022How is your final year going for you, Mr. Dunn?\u0022 you ask.\n\n\u0022Pretty exciting - thanks, doctor! I can\u0027t wait to start my internship year at the University hospital!\u0022 he responds.\n"}]}


{"ops":[{"insert":"\u0022Are you ready to work together with the world renowned specialists there? University hospitals are a goldmine of wisdom and skills for young doctors, but you\u0027ve got to be on your toes clinically, and always be prepared.\u0022\n\n\u0022I\u0027m almost there, I hope!\u0022 answers Mr. Dunn.\n\n\u0022Tell us about your patient, Mr. Dunn,\u0022 says Dr. J.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M39_F3.jpg"}},{"insert":"\n\nYou learn that Biju, a well-built 31-year-old man, presented with feverishness, tiredness, a dry cough, and difficulty in breathing for three months, all of which had gradually worsened over time. The shortness of breath was unrelated to exertion, and markedly worse during weekdays. He felt better during weekends, when at home. \n\nThere was no personal or family history of asthma, allergy, atopy, or pulmonary or cardiovascular diseases. Nor was there a history of exposure to tuberculosis, or of smoking. You also learn that Biju has always been interested in ornithology, and that he had opened a specialty shop to sell a variety of exotic birds and bird supplies. He is unmarried, and keeps two dogs as pets at home.\n\nOn examination, his vital signs were normal, with an unremarkable general examination. The cardiopulmonary examination was also without untoward signs.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M39_F1.jpg"}},{"insert":"\n\nMr. Dunn moves on to the investigations performed. \n\nA complete blood count, metabolic panel, urinalysis, chest x-ray, and tuberculin test were all normal, but Biju\u0027s ESR was 30 mm\/h. Pulmonary function tests showed a mixed obstructive-restrictive pattern. \n\nThese investigations narrow the differentials in your mind, but you feel that Mr. Dunn omitted mentioning one test of crucial importance.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M39_F5.jpg"}},{"insert":"\n\nYou ask: \u0022Mr. Dunn, what about the __________ ?\u0022\n"}]}
1. "Sputum analysis"
2. "Stool analysis"
3. "HIV test"