?Acute bronchitis, Haemetemesis+, Hemoptysis+

90 yrs old male came to casuality with chief complaints of haemoptysis since 2 days(2 episodes)

Pt was apparently asymptotic 2 days ago, later he had cough ass with blood tinged sputum-small quantity

H/O similar complaints for the first time 40-50 yrs back 
From then on and off for every 6-8 months -Not on medication

PAST ILLNESS-

 60 yrs back he had a h/o trauma(Accident) to liver, got admitted in hospital and got operated

40 yrs back-He had a h/o trauma(accident) to  right side of his shoulder and got treated conservatively

20yrs back -He had a h/o  trauma to his front side of right leg-femur fracture and got operated

14yrs back he had h/o of trauma to his left eye for which he went through eye surgery(enucleation) in Hyderabad hospital and his eye got removed.

No H/o asthma,TB, epilepsy, CAD, DM, HTN


On examination : 
Pt is c/c/c
No signs of pallor, icterus, cyanosis, clubbing, lymphadenoapathy, edema

Vitals:
Afebrile
PR: 80 bpm, regular
RR: 20 cpm
BP: 130/80 mmHg
SPO2:
AT ROOM AIR-98%
GRBS:108 mg/dl
Systemic examination :
 CVS:S1,S2 heard
 Apex beat:5th ICS
Resp:
BAE+(vesicular breath sounds)
Nvbs heard 
B/L  Fine crepts+ in IAA, IMA, ICA, ISA
Position of trachea- central

P/A: soft, tenderness absent, bowel sounds heard
Cns: No focal deficit
No meaningeal signs
Glasgow scale-15/15

Provisional Diagnosis-
?Acute Bronchitis
Hematemesis+
Hemoptysis+

Discharged at request

Patient and his attender have been explained about his present condition and risks related to it.Inspite of taking treatment they wanted to go to govt.hospital because they are not willing to pay.

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