50 year old man with haemoptysis

A 50-year-old white man is transferred to your hospital with a presumptive diagnosis of tuberculosis. His chest radiograph shows nodular cavitary lesions in both lung fields. His urinalysis shows 50 RBCs per high power field and 3+ proteinuria. He is scheduled for bronchoscopy with transbronchial lung biopsy in the morning. That evening he has a sudden deterioration consisting of massive hemoptysis and progressive renal failure. The most appropriate therapeutic intervention at this point would be supportive management and

A. IV corticosteroids
B. Antituberculous medications
C. IV cyclophosphamide 4 mg/kg
D. Oral cyclophosphamide 2 mg/kg
E. IV corticosteroids and IV cyclophosphamide 4 mg/kg

40 year old man with productive cough

A 40-year-old, moderately obese man presents with a persistent productive cough. The cough has been present for several weeks, but recently the man noted that his sputum has assumed a greenish color. Further questioning elicits a history of productive cough , usually in the winter months, over the past several years. He has smoked two packs of cigarettes per day since he was 16 years old. On examination, the man is febrile (100° F), and coarse rhonchi and wheezes can be appreciated bilaterally. Which of the following is the most likely diagnosis?

A. Bronchogenic carcinoma
B. Chronic bronchitis with superimposed infection
C. Cystic fibrosis
D. Emphysema
E. Pulmonary tuberculosis