A 44-Year-Old Man Comes to the Emergency Department with a 3-Day

question 306

Multiple Choice

A 44-year-old man comes to the emergency department with a 3-day history of fever, chills, malaise, dyspnea, and a cough productive of "greenish" sputum.  The patient has no prior medical problems and has never been hospitalized.  He has a 25-pack-year smoking history and drinks 4-5 beers a week.  His temperature is 39.4 C (103 F) , blood pressure is 130/80 mm Hg, pulse is 98/min, and respirations are 20/min.  On examination, dullness to percussion, crackles, and higher clarity and intensity sound when he recites "toy-boat" are present at the right lung base.  The remainder of the examination is normal.  Chest x-ray shows a dense infiltrate occupying the entire right lower lobe. 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

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Definitions:

Respirator

A device designed to protect the wearer from inhaling harmful dust, fumes, vapors, or gases.

Joint Tenants

Individuals who own property together with rights of survivorship, meaning upon the death of one tenant, their interest in the property automatically passes to the surviving tenant(s).

Right of Survivorship

A legal principle in joint ownership where the surviving owner(s) automatically inherit the share of a deceased owner.

Executor

An individual appointed in a will to manage the deceased's estate, responsible for settling debts and distributing assets to beneficiaries.