Clinical Case Database / Category: Clinical Care
Breathlessness, lung fibrosis and the limitations of Occam's razor
Publication details
S. Deshmukh, M. Warwick-Sanders, Professor SC. Allen
Foundation Years Journal, volume 2, issue 5, p.236 (123Doc Education, London, June 2008)
Abstract
We present an elderly woman who was admitted to hospital with an apparent exacerbation of a chronic condition. Investigation revealed that her symptoms and signs were caused by three pulmonary pathologies. One was previously diagnosed, one was acute and one became apparent for the first time after admission. We take this opportunity to discuss not only the current guidance available for the management of one of this patient's pathologies, idiopathic pulmonary fibrosis, but also to take a lateral-thinking look at the changing principles of diagnosis and management in an acute medical world populated by many patients of advanced age with pathology in multiple systems.
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Authors
S. Deshmukh
Specialist Registrar
The Royal Bournemouth Hospital
Dorset
M. Warwick-Sanders
Foundation Year 1
The Royal Bournemouth Hospital
Dorset
Professor SC. Allen (Corresponding author)
The Royal Bournemouth Hospital
Castle Lane East
Bournemouth
Dorset
BH7 7DW
stephen.allen@rbch.nhs.uk
References
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2. National Heart and Lung Institute. Respiratory disease. Report on problems, research approaches, needs. Washington: DHEW (NIH) 73â€"432, 1972.
3. Barzo P. Familial idiopathic fibrosing alveolitis. Eur J Respir Diseases 1985; 66:350â€"2.
4. Valeyre D, Soler P, Clerici C, et al. Smoking and pulmonary sarcoidosis. Thorax 1988; 43:516â€"24.
5. British Thoracic Society. The diagnosis, assessment and treatment of diffuse parenchymal lung disease. Thorax 1999; 54(Suppl 1).
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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