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

---

Definitions:

Eminent Domain

The government's power to take private property for public use, with compensation to the owner.

Zoning Rights

Legal regulations determining how specific areas of land can be used, affecting building types, sizes, and purposes.

Community Property

In certain states, all property acquired during a marriage, except for inheritances or gifts received during the marriage by either marital partner. Each spouse has a one-half ownership interest in community property.

Joint Tenancy

The joint ownership of property by two or more co-owners in which each co-owner owns an undivided portion of the property. On the death of one of the joint tenants, his or her interest automatically passes to the surviving joint tenant or tenants.