top of page

Internal Medicine

Public·45 members

A 72 y/o male with a PMH of gout and hyperlipidemia presents to the clinic for chronic persistent cough, dyspnea on exertion and a 50 lb weight loss over the past 4 months.

His cough is mostly dry and reports no recent URTIs/LRTIs. He also complains of night sweats for the past few weeks. He denies having any fevers, headache, blurry vision, chills, N/V, chest pain, palpitations, hemoptysis, orthopnea, diarrhea, constipation, urgency urination or other medical complaints, and has no recent travel history. He has been a professional boxer throughout his life. He stopped training 2 months ago because of his cough and dyspnea.


Patient appears fatigued and weak. Physical examination is unremarkable.

He is currently not taking any medications.

Smoking history: 20 pack years

He denies consuming alcohol or other drugs.

Family history is unremarkable.


WBC 21.1

RBC 4.7

Hb 11.1

MCV 75

Platelets 621

ESR 100

HbA1c 6.2

Cr 0.93

Na 134

K 4.9

Cl 99

HCO3 27

Iron 30 (Low)

Ferritin 654 (High)

TSH 3.2

Rheumatoid Factor 127 (normal: < 14)

Anti CCP, Centromere, SS-A, SS-B, Scl 70, dsDNA antibodies: Negative

HIV Ag/Ab: non reactive

CT thorax attached below.

What are your most likely diagnosis and differentials?

Mazen Kherallah
Ayesha Khan

Thank you @Nader Guma please provide a follow up on the work up that was done and update us once the diagnosis is established

To se mi líbí
bottom of page