Pulmonary

The Southwest Journal of Pulmonary and Critical Care publishes articles broadly related to pulmonary medicine including thoracic surgery, transplantation, airways disease, pediatric pulmonology, anesthesiolgy, pharmacology, nursing  and more. Manuscripts may be either basic or clinical original investigations or review articles. Potential authors of review articles are encouraged to contact the editors before submission, however, unsolicited review articles will be considered.

Rick Robbins, M.D. Rick Robbins, M.D.

April 2017 Pulmonary Case of the Month

Lewis J. Wesselius, MD

Pulmonary Department

Mayo Clinic Arizona

Scottsdale, AZ USA

 

History of Present Illness

A 63-year-old woman with a prior diagnosis of possible rheumatoid arthritis was referred for dyspnea with more vigorous activities in Prescott where she now lives (elevation 5367 ft.). She is receiving hydroxychloroquine 400 mg/day.

Past Medical History, Social History and Family History

She has a past medical history of hypertension. She smoked about a pack per day from age 20 to 40. There is a history of colon cancer in her mother and  lung cancer in a sister.

Physical Examination

  • Vitals: BP 155/102, SpO2 93% on room air
  • Chest: slightly decreased breath sounds but clear
  • Cardiovascular:  regular rhythm without murmur
  • Extremities:  no cyanosis, clubbing or edema
  • The remainder of the physical examination is normal

What testing would you perform at this time? (Click on the correct answer to proceed to the second of five pages)

  1. Chest X-ray
  2. Pulmonary function testing
  3. Rheumatoid factor
  4. 1 and 3
  5. All of the above

Cite as: Wesselius LJ. April 2017 pulmonary case of the month. Southwest J Pulm Crit Care. 2017;14(4):129-33. doi: https://doi.org/10.13175/swjpcc040-17 PDF

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Rick Robbins, M.D. Rick Robbins, M.D.

February 2016 Pulmonary Case of the Month

Ashley Garrett, MD

Karen Swanson, DO

 

Pulmonary Department

Mayo Clinic Arizona

Scottsdale, AZ USA

 

History of Present Illness

A 77-year-old woman presented with dyspnea on exertion which was progressive for several years.  She remains active but is "winded" with vigorous exercise or altitude. She denied cough, orthopnea , paroxysmal nocturnal dyspnea, chest pain or a prior history of pulmonary infections.  

Past Medical, Social and Family History

She has a history of a seizure disorder and fibromyalgia. She has never smoked or drank and has no history of occupational exposures. There was no family history of respiratory disease.

Physical Examination

Her physical exam was unremarkable.

Current Medications

Topamax and alprazolam.

Radiography

A chest radiograph was performed (Figure 1).

Figure 1. Initial chest radiography.

Which of the following describe the initial chest x-ray? (Click on the correct answer to proceed to the second of five panels)

  1. The chest x-ray is normal
  2. There is a left lower mass
  3. There is bronchial dilatation and edema
  4. There is hyperinflation
  5. Three is a retrocardiac left lower pneumonia

Cite as: Garrett A, Swanson K. February 2016 pulmonary case of the month. Southwest J Pulm Crit Care. 2016;12(2):34-40. doi: http://dx.doi.org/10.13175/swjpcc012-16 PDF

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