MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis....
-
Upload
theresa-pitts -
Category
Documents
-
view
213 -
download
1
Transcript of MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis....
![Page 1: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/1.jpg)
MARIAM MUKHTAR
CASE PRESENTATION
![Page 2: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/2.jpg)
CASE:
24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m .
![Page 3: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/3.jpg)
HISTORY
Neonatal history:• Situs inversus & dextrocardia• repeated URTI :Recurrent OM & coryza Chronic ,thick , muciod rhinorrhea• recurrent LRTI :Pneumonia ,bronchiolitis
![Page 4: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/4.jpg)
HISTORY
At age of 3 years:Diagnosed to have asthma: • SOB , chronic cough• Nasal polyps • obstructive pattern of PFT • improvement on BD
![Page 5: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/5.jpg)
HISTORY:
On asthma meds:• Multiple admissions• Symptoms of sinusitis• Worsening of productive cough• recurrent pleural effusions • Thoracotomy & decortication
![Page 6: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/6.jpg)
IMAGING REPORTS
Early childhood:• Situs inversus totalis• Hyper-infilated lungs• Areas of consolidation
Last few years:• Bronchiectatic changes ( progressive) • Opacified sinus cavities • pleural effusion
![Page 7: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/7.jpg)
EXAMINATION
• Normal vitals• Finger clubbing• Chest: basal Coarse crackles, reduced breath
sounds on left side • nose: Pale, edematous mucosa & polyps• Tenderness over sinuses
![Page 8: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/8.jpg)
IMAGING
![Page 9: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/9.jpg)
IMAGING
![Page 10: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/10.jpg)
IMAGING
![Page 11: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/11.jpg)
IMAGING
![Page 12: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/12.jpg)
IMAGING
![Page 13: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/13.jpg)
T R I A D O F B R O N C H I E C T A S I S , C H R O N I C S I N U S I T I S A N D S I T U S I N V E R S U S
KARTAGENER SYNDROME
![Page 14: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/14.jpg)
KARTAGENER SYNDROME
• AR inheritance• defective ciliary motility • 1 /3200 live births• Situs inversus in 50%
![Page 15: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/15.jpg)
CLINICAL MANIFESTATIONS
• Chronic URTI,LRTI• Bronchiectasis• Corneal abnormalities • poor sense of smell• Male Infertility• female sub-fertility
![Page 16: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/16.jpg)
DIAGNOSIS
• 50 visits • Average age 10-14 at diagnosis • Clinical/ tests: nitric oxide test , mucociliary transport test , semen analysis & PFT • Imaging • Biopsy
![Page 17: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/17.jpg)
OTHER ASSOCIATIONS
• transposition of great vessels • Trilocular /bilocular heart• Pyloric stenosis • Polysplenia • Hepatic statosis • Hydrocephalus
![Page 18: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/18.jpg)
IMAGING
Plain films:• Bronchial wall thickening • Bronchial dilatation + loss of normal tapering• Finger in glove sign ( mucus plug)• Situs inversus
![Page 19: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/19.jpg)
KARTAGENER SYNDROME
![Page 20: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/20.jpg)
CT SCANS
• BronchiectasisNon specific tubular or cystic
• Consolidation • Mucocele• Tree in bud or centrolobular nodules• Scarring• Situs inversus• Opacified sinus cavities , hypoplastic frontal
sinuses
![Page 21: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/21.jpg)
KARTAGENER SYNDROME
![Page 22: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/22.jpg)
DIFFERENTIAL DIAGNOSES
• Hereditary impaired muco-cilliary clearance : e.g. CF , Young syndrome
• Impaired immunity:1ry immunodeficiency syndrome, AIDS
• Hyper-sensitvity and immune reaction: e.g. ABPA
• Alpha 1 antitrypsin deficiency
![Page 23: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/23.jpg)
MANAGEMENT
• Medical care:Immunizations , A/B ,inhaled BD ,Steriod , PT • Surgical care:Tympanostomy tubes ,sinus surgeries
• Consultations: ENT , chest ,OB/ GYNE and urology physicians , social workers
![Page 24: MARIAM MUKHTAR CASE PRESENTATION. CASE: 24 year old male patient k/C of asthma and bronchiectasis. c/o: worsening SOB and C/P x 1m.](https://reader030.fdocuments.us/reader030/viewer/2022032606/56649eb15503460f94bb788c/html5/thumbnails/24.jpg)
THANK YOU
References:Medscape Radiopaedia.org.Radiographics journalWikipedia