Examine this pt's chest

I would like to complete my examination by checking for a sputum pot , checking observations fever and O2 saturations.

This gentleman has a respiratory rate of 24/min, has mild clubbing , no nicotine staining or evidence of CO2 retention ,his trachea is central and apex is not displaced.He has reduced air entry from mid zones to the bases with fine end inspiratory crepitations.Vocal resonance and percussion note are normal on both sides. There is no peripheral edema or evidence of pulmonary hypertension.

Based on my findings this gentleman has fibrotic lung disease most likely CFA, but I would like to get more history to rule out other causes of lung fibrosis.

I would like to inx this pt by 1.Sputum for m/c/s, CXR,FBC,ESR,CRP, HRCT,PFT's

Q :How would you manage this patient?
A :I would like to take a full history, with particular interest to occupational and smoking hx, drugs and do a full examination.I would screen and treat for infections and support patient with O2 if required.I would consult Chest Physicians for advice

Q: What would you expect from PFT's and HRCT
A : I would expect a preserved FEV1/FVC ratio of > 80%,but with reduced lung volumes, On HRCT I would expect reticular and honeycomb changes associated with ground glass opacification and traction bronchiectasis mostly in the peripherals and lower lung fileds

Q : What are your differentials
A ;Chest infections , Pneumonia, Heart failure, Drug induced ( amiodarone, nitrofurantoin,mtx,gold, sulphasalazine,)connective tissue dse (SLE, RA,Ank Spond, Bechet's,Slorgren's, Sarcoidosis,Systemic sclerosis, Dermatomyosistis), Industrial dusts , coal asbestos, silicon)

Then the bell rang!