Thursday, February 04, 2010

Crazy Doctors - The Reveal

Once again, if you need to catch up, start here.

Then read this (the cool post with the CT scan).

And now (drumroll please), your answer.

In this case, I noticed that her upper lungs had fibrosis. Fibrosis in the lungs is a rare and bad disease, but it usually only occurs in the lower lungs. It's generally called interstitial lung disease (ILD). Very few things cause upper lobe fibrosis AND exclude the lung bases. One of them is chronic hypersensitivity pneumonitis (CHP), which is the diagnosis in this case. Congratulations if you got it right.

CHP has a variety of causes. One well known cause is exposure to exotic birds, but it can happen with any birds, actually. It's probably exacerbated by an unclean environment. In this case, her morbid obesity is preventing her from adequately cleaning up after her animals. Unfortunately, even if she sells all the chickens and ducks and moves into a totally clean environment, the damage is done. Hopefully it wouldn't progress any further, but you never know.

Thanks for playing along. FWIW, I have a ton of similar cases. If you're interested, I could probably post one a week.


BadBlood said...

I was completely unable to recognize which part of the body I was looking at in those scans. I thought at first, hey, maybe kidneys. Then I said, brain? Nah. Can't be brain. Bowels and intestines? Maybe. Is that a cervix? Fucked if I know.

So what I'm sayin' is, I had a chance of guessing CHP. A very small chance.

bastinptc said...

Great: birds, moldy hay and compost.

With that said, bring on the pathology!

KenP said...

Not sure Doc. I thought I left pop quizzes behind decades ago.

And, sadly, you'd be just one more doctor in a funny outfit trying to enter my life. Although, you don't have a TV show like they do. Seems the regular networks are stealing PBS pledge week programming.

It is interesting to note that doctors are getting their own TV shows because they are so cheap to produce -- don't even have to give prizes. Cheap and around Doctors...amazing!

PrinceofHouston said...

I knew it. It's NEVER lupus.

BLAARGH! said...

YES!!! CHP! I knew it! All those years of art school are finally paying off....

On a more somber note, I did at least know what I was looking at, unfortunately from looking at so many of my dad's xrays. *sigh*