30yo man has progressive SOB and fever for 1 week duration. On examination: Temp 38,5, RR 20/min, trachea is deviated to the left, apex was in the left 5th intercostal space 2 cm lateral to midclavicular line, chest expansion is reduced on rt side with stony dull percussion note. Which the following is the most likely diagnosis?
سؤال مجاني 10 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: C. Pleural effusion
Reduced expansion with a stony dull percussion note on the right, plus trachea and apex shifted to the opposite (left) side, is a large pleural effusion pushing the mediastinum away. Pneumothorax is hyper-resonant; collapse pulls the trachea towards the affected side; pneumonia does not shift the mediastinum.
ليش كل خيار صح أو غلط
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A
ليش غلط
Pneumonia signs are crackles, bronchial breath sounds and enhanced fremitus with dullness; they do not include the tracheal and apex shift seen here.
✓ Pulmonology 🫁.pdf · p. 15 -
B
ليش غلط
Pneumothorax gives hyper-resonance to percussion on the affected side, not a stony dull note.
✓ 7• Pleural Diseases [Notes].pdf · p. 4 -
C
ليش صح
A large pleural effusion gives reduced expansion on the affected side, dullness to percussion, and tracheal deviation away from the effusion.
✓ Pleural effusion.pdf · p. 3 -
D
ليش غلط
In collapse the trachea is displaced towards the collapsed side; here it is deviated to the left, away from the dull right side.
✓ Pulmonology 🫁.pdf · p. 40 -
E
ليش غلط
Pericarditis presents with pleuritic pain worse lying down, better leaning forward, with a pericardial rub; it does not explain stony dullness with a shifted trachea.
✓ view-material.pdf · p. 99
- المصدر
- Pleural effusion.pdf · p. 3
- المحاضرة
- Pleural Effusion & Pneumothorax · Pulmonology · Module B
- ظهر في
- Respi bank