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Pulmonary

Last 50 Pulmonary Postings

(Click on title to be directed to posting, most recent listed first, CME offerings in Bold)

September 2017 Pulmonary Case of the Month
August 2017 Pulmonary Case of the Month
Tip of the Iceberg: 18F-FDG PET/CT Diagnoses Extensively Disseminated 
   Coccidioidomycosis with Cutaneous Lesions
July 2017 Pulmonary Case of the Month
Correlation between the Severity of Chronic Inflammatory Respiratory
   Disorders and the Frequency of Venous Thromboembolism: Meta-Analysis
June 2017 Pulmonary Case of the Month
May 2017 Pulmonary Case of the Month
April 2017 Pulmonary Case of the Month
March 2017 Pulmonary Case of the Month
February 2017 Pulmonary Case of the Month
January 2017 Pulmonary Case of the Month
December 2016 Pulmonary Case of the Month
Inhaler Device Preferences in Older Adults with Chronic Lung Disease
November 2016 Pulmonary Case of the Month
Tobacco Company Campaign Contributions and Congressional Support
   of the Cigar Bill
October 2016 Pulmonary Case of the Month
September 2016 Pulmonary Case of the Month
August 2016 Pulmonary Case of the Month
July 2016 Pulmonary Case of the Month
June 2016 Pulmonary Case of the Month
May 2016 Pulmonary Case of the Month
April 2016 Pulmonary Case of the Month
Pulmonary Embolism and Pulmonary Hypertension in the Setting of
   Negative Computed Tomography
March 2016 Pulmonary Case of the Month
February 2016 Pulmonary Case of the Month
January 2016 Pulmonary Case of the Month
Interval Development of Multiple Sub-Segmental Pulmonary Embolism in
   Mycoplasma Pneumoniae Bronchiolitis and Pneumonia
December 2015 Pulmonary Case of the Month
November 2015 Pulmonary Case of the Month
Why Chronic Constipation May be Harmful to Your Lungs
Traumatic Hemoptysis Complicating Pulmonary Amyloidosis
Staphylococcus aureus Sternal Osteomyelitis: a Rare Cause of Chest Pain
Safety and Complications of Bronchoscopy in an Adult Intensive Care Unit
October 2015 Pulmonary Case of the Month: I've Heard of Katy
   Perry
Pulmonary Hantavirus Syndrome: Case Report and Brief Review
September 2015 Pulmonary Case of the Month: Holy Smoke
August 2015 Pulmonary Case of the Month: Holy Sheep
Reducing Readmissions after a COPD Exacerbation: A Brief Review
July 2015 Pulmonary Case of the Month: A Crazy Case
June 2015 Pulmonary Case of the Month: Collapse of the Left Upper
   Lobe
Lung Herniation: An Unusual Cause of Chest Pain
Valley Fever (Coccidioidomycosis): Tutorial for Primary Care Professionals
Common Mistakes in Managing Pulmonary Coccidioidomycosis
May 2015 Pulmonary Case of the Month: Pneumonia with a Rash
April 2015 Pulmonary Case of the Month: Get Down
March 2015 Pulmonary Case of the Month: Sticks and Stones May
   Break My Bronchi
Systemic Lupus Erythematosus Presenting As Cryptogenic Organizing 
   Pneumonia: Case Report

 

For complete pulmonary listings click here.

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.

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Thursday
Jun012017

June 2017 Pulmonary Case of the Month

Robert Horsley, MD

Lewis J. Wesselius, MD 

 

Department of Pulmonary Medicine

Mayo Clinic Arizona

Scottsdale, AZ USA

 

History of Present Illness

A 61-year-old woman presented to the emergency department for 3 days of fevers up to 102º F, malaise, and progressive shortness of breath. Her symptoms started immediately after he last naltrexone injection for alcohol use disorder.

Past Medical History, Social History and Family History

  • Alcohol use disorder
  • Treated with monthly naltrexone injections, received 3 doses total, and gabapentin
  • No other previous medical issues
  • Nonsmoker

Physical Examination

  • Vital signs: Pulse 100, BP 108/90, respiratory rate 34, SpO2 93% 10L non-rebreathing mask
  • Cyanotic on room air
  • Lungs clear

Radiography

A portable chest x-ray was performed in the emergency department (Figure 1).

Figure 1. AP chest radiograph taken in the emergency department.

A thoracic CT scan was performed (Figure 2).

Figure 2. Representative images from thoracic CT in lung windows.

Laboratory

  • CBC showed a white blood cell count of 12,000 cells/mcL.
  • The differential showed a left shift.
  • Lactate was 5.2 mmol/L

Which of the following is (are) true? (Click on the correct answer to proceed to the second of five pages)

  1. A lactate level of 5.2 can be a normal finding in a critically ill patient
  2. Her symptoms are likely an allergic reaction to naltrexone
  3. The most likely diagnosis is an atypical pneumonia
  4. 1 and 3
  5. All of the above

Cite as: Horsley R, Wesselius LJ. June 2107 pulmonary case of the month. Southwest J Pulm Crit Care. 2017;14(6):255-61. doi: https://doi.org/10.13175/swjpcc063-17 PDF

Monday
May012017

May 2017 Pulmonary Case of the Month

Lewis J. Wesselius, MD

Robert W. Viggiano, MD

 

Department of Pulmonary Medicine

Mayo Clinic Arizona

Scottsdale, AZ USA

   

History of Present Illness

A 69-year-old man with known heart failure, COPD and prostate cancer with presented with increased shortness of breath. He denied any fever, chills, cough or sputum.

Past Medical History, Social History and Family History

  • Diastolic heart failure with a preserved ejection fraction
  • Prostate cancer with bone metastasis treated with leuprolide (Lupron®
  • COPD treated with salmeterol/fluticasone and tiotropium
  • He is married, retired and had quit smoking a number of years ago.
  • Family history was unremarkable

Physical Examination

  • Oxygen saturation (SpO2) was 93% on room air.
  • Physical examination showed jugular venous distention (JVD), bilateral lung rales a laterally displaced pulse of maximal impulse (PMI) and 1+ pretibial edema.

Radiography

A chest x-ray was performed (Figure 1).

Figure 1. Admission chest x-ray.

Based on the history and chest x-ray which of the following is the most likely diagnosis? (Click on the correct answer to proceed to the second of six pages)

  1. Community-acquired pneumonia
  2. Congestive heart failure
  3. COPD exacerbation
  4. Metastatic prostate cancer
  5. Pulmonary embolism

Cite as: Wesselius LJ, Viggiano RW. May 2017 pulmonary case of the month. Southwest J Pulm Crit Care. 2017;14(5):185-91. doi: https://doi.org/10.13175/swjpcc052-17 PDF

Saturday
Apr012017

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

Wednesday
Mar012017

March 2017 Pulmonary Case of the Month

Maxwell L. Smith, MD 

Department of Laboratory Medicine and Pathology

Mayo Clinic Arizona

Scottsdale, AZ USA

 

History of Present Illness

The patient is 52-year-old man who complained of dyspnea on exertion and a dry cough.

 

Past Medical History, Social History and Family History

He had a history of gastroesophageal reflux disease (GERD) and was taking a proton pump inhibitor.

He never smoked and had no known exposures.

Family history was noncontributory.

 

Physical Examination

Physical Examination was unremarkable.

 

Chest X-ray

A chest x-ray was reported as normal.

Which of the following are indicated? (Click on the correct answer to proceed to the second of five pages)

  1. Chest CT scan
  2. Endoscopy/bronchoscopy
  3. Pulmonary function testing
  4. 1 and 3
  5. All of the above 

Cite as: Smith ML. March 2017 pulmonary case of the month. Southwest J Pulm Crit Care. 2017;14(3):89-93. doi: https://doi.org/10.13175/swjpcc014-17 PDF

Wednesday
Feb012017

February 2017 Pulmonary Case of the Month

Abdalla Fadda, MD

Phoenix VA and Banner University Medical Center Phoenix

Phoenix, AZ USA

  

History of Present Illness

A 45-year-old man presented with weight loss, copious amounts of light green sputum, low grade fever and chest discomfort on the right. He had moved to Arizona 8 months ago. Two months later he developed hemoptysis and had increased cough with copious phlegm. He denied any fever, chills, malaise or fatigue.

Past Medical History, Social History and Family History

He has a history of tuberculosis in 2010 treated with 4 drug therapy for a year. The tuberculosis was not drug resistant. He had been treated with a 6-month course of voriconazole about 2 years ago.

Physical Examination

He was afebrile and his vital signs were unremarkable. He had decreased breath sounds in his right lower chest.

Laboratory

His CBC, electrolytes and urinalysis were unremarkable.

Chest Radiography

His admission chest x-ray is shown in Figure 1.

Figure 1. Admission PA of chest.

In regards to the chest x-ray which of the following are true? (Click on the correct answer to proceed to the second of six pages)

  1. There are cavities in the right lung
  2. There is a large right pleural effusion
  3. There is volume loss in the right lung
  4. 1 and 3
  5. All of the above

Cite as: Fadda A. February 2017 pulmonary case of the month. Southwest J Pulm Crit Care. 2017;14(2):45-53. doi: https://doi.org/10.13175/swjpcc005-17 PDF