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Case base learning Respiratory Module CBL 3

Respiratory module CBL  3

A 24 years old married lady from a low socio economic class, presented with complaint of dry cough with occasional sputum and low grade fever for about 6 months. Fever usually occurs in evening with night sweats and remarkable weight loss.

On Examination: Thin, lean lady sitting on bed well oriented with time, place and person.


B.P                  :           90/60mmHg

Pulse                   :       110b/min, regular

Resp / R          :           26 breaths/ min

Temp               :           100° F

Anemia:++,   Jaundice: Nil, Edema: Nil, Clubbing: Nil, Lymph nodes: Not palpable


Chest Examination:

Inspection: Moving symmetrical with respiration. No recession seen

Percussion:      Resonant all over chest.Auscultation:  Decreased breath sounds


Lab Investigations:


Complete Blood Count-

Hb: 8 gm/dl,  MCV: 74 fL, TLC: 12,400/cumm,  Neutrophils: 45%, Lymphocytes: 55%,


ESR: 110mm/hour


Sputum for AFB:  Negative for 3 consecutive days.


Sputum Gene expert: Positive.


Liver FunctionsTest & Urea, Creatinine&Electrolytes:  with in normal limits


X-Ray Chest:  Diffuse miliary shadowing, No nodal involvement.










  1. Identify the patient having tuberculosis.


  1. Describe the pathophysiology of the given pathology.


  1. Interpret different types of tuberculosis.


  1. Define the management for the given scenario.