TRIGGER 1

Gen. Data: BM 70 years old, male, married, retired businessman from Bayawan City, at
the ER for dyspnea and hoarseness of voice.
Problem: Dyspnea and hoarseness of voice
HPI: 5 months PTA, patient noted nonproductive cough. There was no associated fever,
dyspnea or coryza. He self-medicated with Solmux 500mg cap 1 cap PRN and Lagundi
10ml TID, without relief of symptoms. No consult was done at this time.

4 months PTA, nonproductive cough persisted was now associated with gradual 10%
weight loss and exertional dyspnea. He would get out of breath after climbing a flight of
stairs. He self-medicated with Salbutamol 1 nebule PRN with partial relief of symptoms.

1 month PTA, patient was now noted to have hoarseness which he attributed to the
frequent cough. He took Robitussin syrup 10ml TID and he continued his nebulizations.
Dyspnea was now noted even walking from his sala to the kitchen. Progression of
symptoms prompted consult at the ER.

PMHx: Patient is hypertensive for 10yrs and takes Losartan 100mg 1 tab OD. Patient is
not a known diabetic. He had PTB last 2018 under TB DOTS, treatment completed. He had
mild COVID infection in 2021, did home isolation.
No history of allergy.
Received COVID vaccination, Pfizer, 2 doses and 1 booster. No pneumonia or flu vaccines.

PSHx: Smoker since 20 years old at 1 pack per day, stopped 5yrs ago. Occasional alcohol
beverage drinker.

FHx: Family history of hypertension. Mother died of complications from breast cancer.