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.
March 2019 Pulmonary Case of the Month: A 59-Year-Old Woman with Fatigue
Lewis J. Wesselius, MD1
Michael B. Gotway, MD2
1Department of Pulmonary Medicine and 2Department of Radiology
Mayo Clinic Arizona
Scottsdale, AZ USA
History of Present Illness
A 59-year-old woman from Kingman, Arizona had a one-year history of fatigue with some shortness of breath. For this reason, she saw her primary care physician.
Past Medical History, Social History and Family History
She has no significant past medical history. She does not smoke. Family history is noncontributory.
Physical Examination
Physical examination was unremarkable.
Which of the following should be done? (Click on the correct answer to be directed to the second of seven pages)
- Chest x-ray
- Complete blood count
- Electrolytes, blood urea nitrogen and creatinine
- Liver panel
- All of the above
Cite as: Wesselius LJ, Gotway MB. March 2019 pulmonary case of the month: A 59-year-old woman with fatigue. Southwest J Pulm Crit Care. 2019;18(3):52-7. doi: https://doi.org/10.13175/swjpcc008-19 PDF
January 2013 Pulmonary Case of the Month: Maybe We Should Call GI
Lewis J. Wesselius, MD
Department of Pulmonary Medicine
Mayo Clinic Arizona
Scottsdale, AZ
History of Present Illness
A 55 year old man from Arizona was undergoing a renal transplant evaluation because of polycystic kidney disease. He was referred for an abnormal chest x-ray. He was a nonsmoker and there were no respiratory symptoms.
PMH, FH and SH
He has a long history of polycystic kidney disease, hypertension, gout, and a history of a kidney stone. He is a life-long nonsmoker. There is no significant family history including polycystic kidney disease. He works as a border patrol agent and is originally from Honduras. His present medications include:
- Allopurinol
- Amlodipine
- Atenolol
- Hydralazine
- Sodium bicarbonate
Physical Examination
His blood pressure is elevated at 142/84, but otherwise his physical examination is unremarkable.
Chest X-ray
His chest X-ray is below (Figure 1).
Figure 1. PA (Panel A) and lateral (Panel B) chest x-ray.
The chest x-ray was interpreted as showing bilateral lower lobe nodules.
Which of the following is appropriate?
- Obtain old chest x-rays for comparison
- Spiral CT for pulmonary embolism
- Coccidioidomycosis serology
- A + C
- All of the above
Reference as: Wesselius LJ. January 2013 pulmonary case of the month: maybe we should call GI. Southwest J Pulm Crit Care 2013;6(1):46-51. PDF