I have caught up with Christina a month since the last appointment. The cough has now resolved but as you are aware in the last few weeks Christina has developed some new symptoms. She reports the onset of fatigue, increased breathlessness and postural lightheadedness that is also quite severe if she bend forward quickly. She has almost reached a point of passing out but has not had any actual syncopal episodes.

Christina underwent a CT chest scan one week ago and unfortunately this was a poor quality study some motion artefact. Nonetheless there was impression of increased interstitial markings with some ground glass nodules sub-plurally in the upper zones whilst patchy going glass densities have been reported in the lower zones, but