A 68-Year-Old Man Comes to the Emergency Department Due to Cough

question 8

Multiple Choice

A 68-year-old man comes to the emergency department due to cough, breathlessness, and chest pain.  The patient has a medical history of hypertension and type 2 diabetes mellitus.  He is a former smoker with a 20-pack-year history.  Temperature is 38 C (100.4 F) , blood pressure is 130/80 mm Hg, respirations are 22/min, and oxygen saturation is 95% while breathing ambient air.  The trachea is central in position.  There is dullness to percussion over the lower right lung area compared to the resonancy on the left.  Auscultation of the right lower lobe reveals breath sounds that are loud, hollow, and high-pitched.  When the patient recites the word "ninety-nine" in a normal voice, the sound has higher clarity and intensity over the right base compared to other lung areas.  Which of the following is the most likely cause of these findings?

• A)Accumulation of interstitial fluid within the pleural space
• B)Embolic occlusion of a pulmonary segmental artery
• C)Exudation of neutrophil-rich fluid in the lung parenchyma
• D)Leakage of air from spontaneous rupture of visceral pleura
• E)Lung collapse due to a mass causing bronchial obstruction
• F)Transudation of interstitial fluid within the alveolar spaces

---

Definitions:

False Positive Reaction

Occurs when a test or analysis incorrectly identifies the presence of a condition or attribute that is actually not present.

Dangerous

Involving potential harm or risk to safety, health, or well-being.

Pitfalls

Hidden dangers, problems, or unforeseen challenges that can complicate actions or decisions.

Glass Cliff

The phenomenon where women or minority leaders are more likely to be placed in leadership roles during times of crisis or organizational decline, posing a higher risk of failure.