Gentian Balashi Case Study

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Thank you for referring Gentian Balashi, a 37-year-old gentleman of Albanian origin who immigrated to Australia 18 year ago. Gentian is a current smoker of 10-15 cigarettes per day and in total has smoked for five years. He works as a farmer and keeps pet dogs. His only regular medication is Nexium.

Gentian reports a history of childhood asthma and frequent upper respiratory tract infections. Over the last couple of years, he has been aware of intermittent wheeze, a cough productive of small amounts of thick discoloured phlegm and intermittent dyspnoea. There has also been sino-nasal congestion with post-nasal drip. Gentian does not report typical allergic rhinitis symptoms. He also experiences frequent reflux symptoms.

A couple …show more content…

As you are aware, Gentian has had a couple of CT chest scans, the most recent of which has commented on a 6mm right lower lobe superior segment nodule and a 4mm nodule in the lateral basal segment of the left lower lobe. There are no other obvious parenchymal abnormalities.

On review today, Genian is comfortable at rest with an oxygen saturation of 97%. Oropharyngeal inspection revealed some crowding, but no oropharyngeal secretions. Chest auscultation was clear and two heart sounds were audible with nil else.

Assessment:
Concerning the pulmonary nodules, pleasingly these have not changed over a two-year period and I have reassured Gentian that these will be benign and post-inflammatory in nature. No further imaging is required.

Concerning his ongoing symptoms, it is likely that he has some mild asthma in association with low-grade rhinosinusitis and intermittent reflux. I have advised him to continue with Nexium, but he will commence Alvesco 160mvg daily and intranasal saline and steroid sprays.

I will see him again in a few weeks, at which point we will perform lung function tests to get an objective measure of his asthma control.

Thank you again for your

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