Case presentation A 55-year-old man has presented to the ED with a two-week history of hemoptysis, dry cough, and shortness of breath. He has also noticed that his urine has become darker. He returned from a tour four weeks ago and has felt non-specifically unwell since. He smokes 15 cigarettes daily and drinks 4 pints of beer per week.
PMH : None Examination This man has bibasal inspiratory crackles on the auscultation of the chest. The rest of the cardiorespiratory, abdominal, and neurological examination is normal. A chest X-ray shows patchy bilateral shadowing in the lower zones. Observations: BP: 165/85 mmHg HR: 85/min RR: 24/min SaO 2 92 percent on room air WCC: 9.2 X 10 9 /L Hb: 11 g/dL Mean cell volume: 76 fL Platelets: 450 X 10 9 /L Sodium: 138 mmol/L Potassium: 5.0 3.5–5.0 mmol/L Urea: 19 mmol/L Creatinine: 280 mmol/L INR: 1.2 Urine dipstick: Blood +++ Urine microscopy: Red…
