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Thread: Dx 2

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    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    Dx 2

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    A 60-year-old man presents to the emergency department complaining of shortness of breath, cough, and copious sputum production. He states that he has been coughing for years, and has had increased sputum production for several months each year. On examination, he is obese, afebrile, cyanotic, and in acute distress. Coarse rales are auscultated bilaterally at the lung bases. He smokes two packs of cigarettes a day and has a seventy-five pack-year smoking history. A chest x-ray film appears normaI, except for slightly enlarged lung fields.



    Which of the following is the most likely diagnosis?
    / A. Chronic bronchitis
    / B. Emphysema
    / C. Myocardial infarction
    / D. Pneumonia
    / E. Pulmonary embolus
    Last edited by IMG SURVIVOR; 10-25-2008 at 10:24 PM.
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    why even bother with the obvious. Just know where you are need it and where you can help the most.

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    The correct answer is A. This patient has findings classic for the "blue bloater" of chronic bronchitis. Patients with chronic bronchitis have excessive tracheobronchial mucus production sufficient to cause cough with expectoration for at least three months of the year for more than two consecutive years. "Blue bloaters" are named for their obese body habitus, copious sputum production, and cyanotic episodes. This condition may occur initially without airway obstruction, but eventually, most patients progress to obstructive disease.
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

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