Question

History
A 19-year-old boy has a history of repeated chest infections. He had problems with a cough
and sputum production in the first 2 years of We and was labelled as bronchitic. Over the next
14 years he was often 'chesty and had spent 4-5 weeks a year away from school. Over the
past 2 years he has developed more problems and was admitted to hospital on the occasions
with cough and purulent sputum. On the first two occasions, Haemophilus influenzae was grown
on culture of the sputum, and on the last occasion 2 months previously Pseudomonas
aeruginosa was isolated from the sputum at the time of admission to hospital. He is still
coughing up sputum. Although he has largely recovered from the infection, his mother is womed
and asked for a further sputum to be sent off. The report has come back from the microbiology
laboratory showing that there is a scanty growth of Pseudomonas on culture of the sputum.
There is no family history of any chest disease, Routine questioning shows that his appetite
is reasonable, micturition is normal and his bowels tend to be irregular
Examination
On examination he is thin weighing 48 kg and 16 m (5 46 in) tall.
• The only finding in the chest is of a few inspiratory crackles over the upper zones of
both lungs. Cardiovascular and abdominal examination is normal.
Questions
What does the X-ray show?
- What is the most likely diagnosis?
What investigations should be performed?

Answer 1

Xray will show nothing and the required diagnosis is endoscopy........      And investigaition should  be done according to the report of the endoscopy....