A 54-year-old woman has a 7-day history of cough and dyspnea. On examination, her temperature is 37.9, BP is 105/70 mmHg, pulse rate is 106/min, oxygen saturation is 92% on room air. Lung examination reveals dullness to percussion, decreased tactile fremitus, and decreased breath sounds at the right lung base Which of the following is the most likely diagnosis?
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الإجابة والشرح
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الإجابة: A. Pleural effusion
Stony dullness + reduced tactile fremitus + reduced/absent breath sounds at a lung base is the classic triad of pleural effusion (fluid damps transmission of vibrations), here likely parapneumonic given the fever. Lobar consolidation is also dull but gives increased tactile fremitus and bronchial breath sounds. Pneumothorax is hyper-resonant, not dull.
ليش كل خيار صح أو غلط
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A
ليش صح
Reduced tactile fremitus, dullness to percussion and faint or absent breath sounds over the base are the signs of a pleural effusion (fluid in the pleural space).
✓ Pleural effusion.pdf · p. 3 -
B
ليش غلط
Heart failure is an underlying cause of an effusion, with its own symptoms; the signs found here (dullness, reduced fremitus, reduced breath sounds at one base) are those of the effusion itself.
✓ Pleural effusion.pdf · p. 3 -
C
ليش غلط
Pneumothorax gives hyper-resonance to percussion on the affected side, not dullness.
✓ 7• Pleural Diseases [Notes].pdf · p. 4 -
D
ليش غلط
Lobar consolidation is dull too, but it gives increased tactile and vocal fremitus and bronchial breath sounds, whereas this patient has decreased fremitus and breath sounds.
✓ Step Up To Medicine 6th Edition 2024 (Pneumonia).pdf · p. 2
- المصدر
- Pleural effusion.pdf · p. 3
Step Up To Medicine 6th Edition 2024 (Pneumonia).pdf · p. 2 - المحاضرة
- Pleural Effusion & Pneumothorax · Pulmonology · Module B
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