Question

Mr Mundia presents with right sided chest pains and occasional haemoptysis. He has no known comorbidities, he exercises regularly, occasional drinker and a heavy smoker. The family and medical history is unrevealing. Discuss what you expect to find on the chest x-ray, CT chest, MRI chest and the SPECT images for this patient.

Answer 1

Hemoptysis is the coughing up of frank blood or blood - stained mucus/ pus from the lungs and it is an important indicator of Pathology.careful the assessment of history,clinical examination and investigations will help elicit the source of hemoptysis.

Already patient is smoking and drinking also little bit exercise only .and discuss about the investigations

Chest X - ray : chest x- ray is strongly recommended in patients over 40 presenting with unexplained hemoptysis.smokers are at especially high rsik for lung cancer which may appear as a new or enlarged focal lesion. Other signs of malignancy include effusion,mediastinal lymphadinopathy NAD consolidation.chest X- ray can also gives clues to tuberculosis,pneumonia and pulmonary edema,pulmonary embolism.

CT computerized tomography , CT is the imagine modality of choice in many of the conditions described above.it can help differentiate the etiology of a lesion or opacification seen on X- ray.it will generally show the same findings but with increased detail.

CT pulmonary angiography is the gold standard of diagnosis in pulmonary embolism and high resolution CT is key in bronchiectasis diagnosis.CT is a better option for investigating pulmonary manifestation of good pasture syndrome and granulomatosis with polyangitis

Chest MRI can provide detailed information to help your doctor diagnose lung problems such as a tumor or plural disorder,blood vessel problems, or abdominal lymph nodes.chest MRI scan help explain the results of other imaging tests such as chest X - ray and chest CT.

SPECT :- single photon emission computed tomography.

SPECT can use radio active material called tracers.the tracers mix with your blood and are taken up by living Heart muscle.A special gamma camera picks up signals from the tracers as it moves around your chest..SPECT scans can also give information about how well your Herat is pumping.

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