A 55-Year-Old Man Is Evaluated for New-Onset Shortness of Breath

question 375

Multiple Choice

A 55-year-old man is evaluated for new-onset shortness of breath after a right hemicolectomy 3 days ago.  He has no chest pain, cough, or hemoptysis.  The patient came to the hospital 4 days ago with a history of constipation, weight loss, and abdominal distension.  He was found to have an obstructing cecal mass and underwent right hemicolectomy with ileocolic anastomosis.  The patient has no significant medical history other than a 35-pack-year smoking history.  Temperature is 37.2 C (99 F) , blood pressure is 120/80 mm Hg, pulse is 98/min, and respirations are 22/min.  Pulse oximetry shows 88% on room air.  Lung examination reveals dullness to percussion and absence of breath sounds on the left.  Chest x-ray is shown below. Chest x-ray at the time of admission was normal.  Which of the following is the most likely cause of this patient's pulmonary findings?

• A)Bronchial mucus plug
• B)Diaphragm perforation
• C)Endobronchial tumor
• D)Large pleural effusion
• E)Multilobar pneumonia
• F)Tension pneumothorax

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Definitions:

Susceptible

Likely or liable to be influenced or harmed by a particular thing.

Amenorrhea

The absence of menstruation in a woman of reproductive age.

Menopause

The cessation of menstruation.

Menstruated

The process of menstruation, which is the monthly shedding of the uterine lining in females, typically associated with the reproductive cycle.