November 2015 pulmonary case of the month

No abstract available. Article truncated after 150 words. History of Present Illness: A 66 year-old woman was admitted to neurology with acute-onset dysarthria, right facial droop, and right-sided hemiparesis as a stroke alert. She also had a nonproductive cough and intermittent dyspnea for 4 months. Past Medical History, Social History and Family History: She has a history of hypertension and hyperlipidemia. She smoked 1-2 packs/day for 15 years but quit 35 years ago. She drinks two glasses of wine per day. There is a family history of bowel and breast cancer. Physical Examination: Vital signs: T 36.8, HR 81, BP 129/75, RR 18, O2 sat 93% RA. General: No acute distress. Awake and alert. Heart, abdomen, and lungs: No significant abnormalities. Neurological: Mild right-sided nasolabial fold flattening. Evidence of ptosis o the right eyelid. Hemiparesis on the right, the arm greater than leg. Sensation intact. Dysmetria on the right upper and lower extremities. Laboratory Evaluation: CBC: Hemoglobin 11.9 ..