P2 Case B

A patient is referred to your Pulmonology clinic. He is a 67 yo man with a 20 pack year smoking history, hypertension, hyperlipidemia, and rheumatoid arthritis. He was referred to you by his Primary Care Physician for a better assessment of his complaints of dyspnea. He recently retired from his work as an electrician for military naval yard. Despite his retirement, he has continued to work on his passion to do the re-do wiring in homes in his community, usually built in the 60's and 70's, though, he has been unable to do so this past month due to increased difficulty in breathing. He denies fevers, chills, hemoptysis, and recent weight loss.

1. Amongst the following pulmonary pathology images, select the most likely to be found in your patient. In addition, describe each image's lung pathology and name the diagnosis.


A.

B.

C.

2. His concomitant diagnosis of Rheumatoid Arthritis suggests this disease.



3. You always remember a litigation associated with the pulmonary disease you've diagnosed him with at your clinic. Use the following images to name these well-known possible complications.