The previous question:

A 28 year old female with asthma which is normally well controlled presents with worsening wheeze. She states this
is associated with a productive cough and on occasion the sputum has been blood stained. This is also associated
with malaise and severe headache. This has occurred on several occasions over the last few months. Her family
owns a farm. As her father died recently she has been helping out on the farm. Bloods reveal an eosinophilia and
raised IgE. A CXR shows evidence of pulmonary infiltrates. Given the most likely diagnosis, what treatment should
be commenced?
Your answer was Prednisolone which is correct
Prednisolone correct answer
Nil specific
Amoxicillin
Salbutamol inhaler
Azathioprine
Explanation:
The most likely diagnosis is allergic bronchopulmonary aspergillosis. It is a hypersensitivity reaction to the
colonisation of the airways with Aspergillus which is often found in mouldy hay and soil. It is usually affects
patient with asthma and cystic fibrosis. Patients have a raised IgE, eosinophils and aspergillus positive.
Prednisolone is utilised for treatment.
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Question category: Respiratory
A 38 year old male returned from travelling around Asia 6 months ago. He
presents with a nocturnal dry cough, shortness of breath and wheeze. He is
commenced on a salbutamol inhaler. However he returns with fever, weight
loss and listlessness. Bloods reveal an eosinophilia and elevated IgE. A CXR
reveals bilateral hazy mottling. Which of the following is the most likely
diagnosis?
Churg-Strauss Syndrome
Tropical Pulmonary Eosinophilia
Aspergilloma
Asthma
Allergic Bronchopulmonary Aspergillosis
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