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Respiratory system overviewDownloads

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1

A 3-year-old girl is brought to the emergency department by her parents with sudden onset shortness of breath. They tell the emergency physician that their daughter was lying on the bed watching television when she suddenly began gasping for air. They observed a bowl of peanuts lying next to her when they grabbed her up and brought her to the emergency department. Her respirations are 25/min, the pulse is 100/min and the blood pressure is 90/65 mm Hg. The physical findings as of now are apparently normal. She is started on oxygen and is sent in for a chest X-ray. Based on her history and physical exam findings, the cause of her current symptoms would be seen on the X-ray at which of the following sites?

AThe superior segment of the right lower lobe

BThe posterior segment of the right lower lobe

CThe lingula of the left upper lobe

DThe apical segment of the right upper lobe

EThe apical segment of the left upper lobe

2

A 60-year-old man comes to the clinic complaining of a persistent cough for the last few months. His cough started gradually about a year ago, and it became more severe and persistent despite all his attempts to alleviate it. During the past year, he also noticed some weight loss and a decrease in his appetite. He also complains of progressive shortness of breath. He has a 40-pack-year smoking history but is a nonalcoholic. Physical examination findings are within normal limits. His chest X-ray shows a mass in the right lung. A chest CT shows a 5 cm mass with irregular borders near the lung hilum. A CT guided biopsy is planned. During the procedure, just after insertion of the needle, the patient starts to feel pain in his right shoulder. Which of the following nerves is responsible for his shoulder pain?

AThoracic spinal nerves

BPhrenic nerve

CVagus nerve

DPulmonary plexus

EIntercostal nerves

3

A 45-year-old male alcoholic presents with fever, productive cough, and foul-smelling sputum for the past two weeks. Vital signs are T 38.3 C, HR 106, BP 118/64 and RR 16. Oxygen saturation on room air is 90%. Given a diagnosis of aspiration pneumonia, initial chest radiograph findings would most likely include:

AMediastinal abscess located between vertebral levels T1-T3

BLeft lung abscess due to increased ventilation-perfusion ratio of the left lung

CRight lung abscess due to the right main bronchus being wider and more vertically oriented

DRight lung abscess due to increased anterior-posterior diameter of the right lung

ELeft lung abscess due to the left main bronchus being located superior to the right main bronchus

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