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A 42-Year-Old Man Comes to the Physician with 4-6 Weeks

question 108

Multiple Choice

A 42-year-old man comes to the physician with 4-6 weeks of occasional subjective fever, mild shortness of breath on exertion, intermittent cough, and right-sided chest pain. The patient was started on chlorthalidone for hypertension 4 months ago. He has smoked 2 packs of cigarettes daily for 15 years. The patient emigrated 14 years ago from Russia, where he used to work in construction and building demolition and did not wear a respirator mask at work. He has lived in Chicago since his arrival to the United States.
The patient's temperature is 37.3 C (99.1 F) . Lung examination is significant for decreased breath sounds at the right base.
Chest x-ray reveals a small right-sided effusion with mild pleural thickening. A thoracentesis is performed.

What is the most likely cause of the effusion?

Definitions:

Respiratory Membrane

The respiratory membrane is the barrier through which gas exchange occurs between the air in the lungs and the blood in the capillaries.

Diffusion

The movement of molecules from an area of higher concentration to an area of lower concentration, a fundamental process in physics and biology.

Alveolar Ventilation Rate

The rate at which air moves in and out of the alveoli, the tiny air sacs in the lungs, crucial for gas exchange.

Minute Respiratory Volume

The total volume of air breathed in and out by a person at rest in one minute, important in assessing respiratory health.