Muhamad Na'im B Ab Razak (jacknaim) is a fresh graduate Muslim Doctor from Universiti Sains Malaysia and waiting for the enrollment into the housemanship program. Ambitious in pursuing master program in emergency and traumatology medicine and loves to spent his free time joining humanitarian missions, writing and speaks as an amateur public speaker in motivation and comparative religion. [HOME]

65 years old man with prolong fever and coughing out blood


Answer


1) Chest X ray finding

i. Bilateral fibrotic lung changes

ii. Cavitation at right middle lung zone

iii. Haziness of right cardiophrenic and costophrenic angle


2) Primary pulmonary tuberculosis


3) Further investigation

i. Full blood count

ii. Early morning sputum for Acid fast bacilli

iii. Mantoux test

iv. ESR + CRP (ESR alone is not sensitive and specific for TB. Combining it with CRP will increase the sensitivity of the test. ESR will usually be very high more than 100 mm/hr)