A 60 year old male presented with cough, progressive breathlessness and hemoptysis. He is a current smoker, and worked as a mechanic. His mother had been treated for pulmonary TB a few years ago. Urinalysis shows blood +++, protein ++, numerous red cell casts. CXR was done (see below).
click image to enlarge
This is his lung function-
FEV1 65% predicted
FVC 60% predicted
TLC 68% predicted
RV 66% predicted
TLCO 110% predicted
What is the management plan?
A. Steroid, brochodilators
B. Early plasmapharesis, methyprednisolone, cyclophosphamide
C. Anti-TB drug
D. Antibiotics for bacterial chest infection
E. Diuretics

click image to enlarge
This is his lung function-
FEV1 65% predicted
FVC 60% predicted
TLC 68% predicted
RV 66% predicted
TLCO 110% predicted
What is the management plan?
A. Steroid, brochodilators
B. Early plasmapharesis, methyprednisolone, cyclophosphamide
C. Anti-TB drug
D. Antibiotics for bacterial chest infection
E. Diuretics