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Free notes, MCQs, tables & flowcharts for USMLE Step 1 Pathology
A 27-year-old man presents to the emergency department with severe dyspnea and sharp chest pain that suddenly started an hour ago after he finished exercising. He has a history of asthma as a child, and he achieves good control of his acute attacks with Ventolin. On examination, his right lung field is hyperresonant along with diminished lung sounds. Chest wall motion during respiration is asymmetrical. His blood pressure is 105/67 mm Hg, respirations are 22/min, pulse is 78/min, and temperature is 36.7°C (98.0°F). The patient is supported with oxygen, given corticosteroids, and has had analgesic medications via a nebulizer. Considering the likely condition affecting this patient, what is the best step in management?
ACT scan
BABG
CChest X-rays
DTube insertion
ESonogram
An x-ray of the chest is conducted and shown below. Which of the following is the most appropriate next step in management?
AAdminister isoniazid for 9 months
BRepeat PPD skin test
CObtain a chest CT scan
DPerform interferon-γ release assay
EAdminister isoniazid + rifampin + pyrazinamide + ethambutol
A 61-year-old man comes to the physician because of a 3-month history of worsening exertional dyspnea and a persistent dry cough. For 37 years he has worked in a naval shipyard. He has smoked 1 pack of cigarettes daily for the past 40 years. Pulmonary examination shows fine bibasilar end-expiratory crackles. An x-ray of the chest shows diffuse bilateral infiltrates predominantly in the lower lobes and pleural reticulonodular opacities. A CT scan of the chest shows pleural plaques and subpleural linear opacities. The patient is most likely to develop which of the following conditions?
AMalignant mesothelioma
BSpontaneous pneumothorax
CBronchogenic carcinoma
DAspergilloma
EMycobacterial infection
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