BOF: 33
A 45-year-old male homeless alcoholic has been referred
to the medical ward after being brought in to casualty. He has a chronic cough
productive of sputum, loss of weight, and night sweats. On examination he is
unkempt and emaciated. His trachea is deviated to the left and there are
crepitations over the apex of the left lung. CXR shows fibrosis and cavitation
in the left apex.
The investigation most likely to confirm the diagnosis
would be
a)
Sputum examination for acid and alcohol fast bacilli
b)
High resolution CT scan
c)
Fibreoptic bronchoscopy
d)
Mantoux test
e)
Gastric washings
Answer:
a)
The patient has a productive cough. The chances are that
AAFB will be identified in these specimens. If sputum were not produced
bronchoscopy would be preferred to gastric washings.
