CLINICAL HISTORY
The next case is a 56-year-old man who initially presented with weight loss, loin pain, haematuria and painful inflamed joints. He also complained of a persistent unproductive cough which had been worsening over the past three months. On further questioning, he revealed that he had felt a bit 'off-colour' for about a year, but had not felt that it was anything to bother his GP about; he had also developed a pronounced wheeze and some chest pain.
Previous medical history; exertional angina and hypertension (diagnosed 8 years ago), and appendicitis (6 years ago).
Drug history: Thiazide diuretics- the patient had been taking these since his hypertension was diagnosed.
He was admitted to hospital, where a chest X-ray and blood samples were taken; the blood sample showed polycythaemia (see dictionary)
The patient's condition worsened over the next week, and he developed frank oedema which further impaired his breathing. Three days later, the patient arrested; rescusitation was unsucessful and the patient died.