A new concept I learned

,

This was a good question about a 50 years old male, who is suffering from, type2 D.M. , Hypertension and  smokes half a pack of cigarettes per day for successive 7 years,  he developed DRY cough and gradually progressive dyspnea , examination showed diffuse lung crackles, x-ray showing diffuse reticulonodular densities , and CT scan showed TRACTION bronchieactasis, the next question what should you give to start ttt prednisone or B agonist ?

I chose B- agonist, why I got it wrong?

I rapidly thought smoker >> COPD >> mentioned bronchiectasis >> look for B-agonist and antibiotics also he is a diabetic and prednisone would be harmful, that’s how I tricked myself

Although the answer is quietly obvious,

It was prednisone to be given in a trial to stop gradually progressive interstitial lung fibrosis a disease occurs around 5^th decade of life and characterized byequal distribution among males and female, associated with progressive lung fibrosis and TRACTION bronchiectasis , pulmonary HTN and cor-pulmonale.

The answer was obvious with key words DRY cough which isn’t the case with bronchiectasis and COPDs with recurrent chest infections and copious sputum production, 50 years wasn’t going to be guiding enough but traction bronchiectasis could seal the diagnosis or may trick you like it did with me : ))