A 23-Year-Old Man Comes to the Emergency Department Due to Hemoptysis

question 524

Multiple Choice

A 23-year-old man comes to the emergency department due to hemoptysis.  The patient has had increasing dyspnea over the past several months.  Today, he coughed up approximately 20 mL of blood.  He also reports frequent episodes of epistaxis since childhood but has no other medical conditions.  The patient does not use tobacco, alcohol, or illicit drugs.  Temperature is 37.2 C (99 F) , blood pressure is 110/60 mm Hg, and pulse is 98/min.  Physical examination shows clear lungs, but there is a faint, continuous bruit on the right infrascapular region.  Laboratory evaluation shows microcytic anemia and a normal urinalysis.  Chest x-ray reveals several round lung nodules with well-demarcated, smooth borders and no calcifications.  Which of the following is the most likely cause of this patient's hemoptysis?

• A)Arteriovenous malformations
• B)Disseminated tuberculosis
• C)Granulomatosis with polyangiitis
• D)Pulmonary histoplasmosis
• E)Septic emboli

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Definitions:

Latent Learning

describes the process by which learning takes place without immediate evidence of that learning, often becoming apparent through a change in behavior when it's beneficial.

Mary Cover Jones

An early psychologist known for her work on desensitization and counterconditioning, particularly in relation to overcoming fears.

Classical Conditioning

A learning process that occurs when two stimuli are repeatedly paired: a response that is at first elicited by the second stimulus is eventually elicited by the first stimulus alone.

Fear

An emotional response to perceived or real threats.