Entry no. 48 – Ashima Palia [Event name : Dr. Sherlock – The Science of Deduction]

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A 55 – year old man with a history of a chronic lung disease presents to his primary care physician with worsening shortness of breath. He was diagnosed about 1 year ago. He gives a history of smoking cigarettes (one pack a day for 30 years ) but has no other medical problems. His general appearance is of a thin male who appears to be in a mild distress. His cardiac examination is normal, but he is noted to have an extended antero-posterior of the chest with expiratory wheezes and breathing through pursed lips. A chest X-ray reveals hyperinflated lung fields bilaterally and no infiltrates.

1. What are differential diagnosis ?
2. What is most probable diagnosis ?
3. How do you approach to diagnosis ?
4. What is the management of the case ?

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