To: Dr.

Mansour Al-Hamli, Radiologist

From: Dr. Jamal Al-Sabahi, Senior Specialist in Internal Medicine
Date: [Current Date]
Subject: Request for Chest CT Scan for Patient Zayed Ali Al-Jarahumi

Patient Details:
Name: Zayed Ali Al-Jarahumi
Age: 32 years
Gender: Male

Clinical Summary:
Presenting Complaints:
- Progressive dyspnea over the last two months
- Worsening dyspnea at rest over the last week
- Associated symptoms: hemoptysis, fever, and cough
Medical History:
- No known chronic medical illness
- No history of oral or genital ulcers
- No definitive history of arthritis, but reports of polyarthralgia
Examination Findings:
- Conscious and oriented
- Mild cyanosis, no pallor or jaundice
- Tachypnea and respiratory distress
- Decreased air entry in the right lower lung with bilateral crackles
- Normal heart sounds, soft abdomen with no significant findings
Vital Signs:
- Blood Pressure: 110/70 mmHg
- Pulse: 110 beats per minute
- SpO2: 90% on oxygen therapy
Investigations:
- Hemoglobin: 13.7 g/dL
- WBC Count: 23.3 x10^9/L (neutrophilia)
- Platelets: 256 x10^9/L
- ESR: 98 mm/hr
- Random Blood Sugar: 5.71 mmol/L
- Creatinine: 174 µmol/L
- CRP: Positive (144 mg/L)
- Urine Examination:
 - Color: Yellow
- Appearance: Turbid
- Specific Gravity: 1.025
- pH: Acidic
- Protein: Positive 1+
- Red Blood Cells: 4-6 /HPF
- White Blood Cells: 8-10 /HPF
- Epithelial Cells: 2-4 /HPF
- Casts: Hyaline Casts 2+, Granular Casts 1+
Previous Imaging:
- CT scan showing bilateral diffuse alveolar opacities consistent with pulmonary
hemorrhage or infection

Request:
Given the patient's clinical presentation, laboratory findings, and initial imaging results, I
request a detailed Chest CT scan to further evaluate the extent and nature of the
pulmonary abnormalities. The differential diagnoses under consideration include:
- Goodpasture Syndrome
- Granulomatosis with Polyangiitis (Wegener's Granulomatosis)
- Severe Pneumonia
- Sepsis
- Systemic Lupus Erythematosus (SLE)
- Microscopic Polyangiitis
The detailed imaging will assist in guiding further management and treatment plans.

Please address any findings and recommendations to my attention at your earliest

convenience. Thank you for your prompt assistance.

Sincerely,
Dr. Jamal Al-Sabahi
Senior Specialist in Internal Medicine
[Your Contact Information]