Pneumonology Quiz – Case 5 (free article from 2017 Archives of Hellenic Medicine)

A 78-year-old male patient presented in the emergency department with a gradual deterioration of his general state of health during the preceding month. More specifically, he complained of progressive breathlessness, retrosternal pain radiating throughout his thoracic cavity, dizziness, syncopal episodes and cough, productive of small quantities of pink-tinted phlegm, mainly on exertion. At presentation, the patient appeared severely unwell. He was pale and he scored four in the modified Medical Research Council (mMRC) breathlessness score.

Pulmonary auscultation revealed bilateral coarse crackles throughout the lung fields. Heart sounds were rhythmic, characterized by a loud ejection systolic murmur clearly audible in all auscultation areas and diminished heart sounds in the aortic area. His heart rate was 80 beats per minute and his blood pressure was 100/60 mmHg. 

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Pneumonology Quiz - Case 1

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Pneumonology Quiz – Case 3

Pneumonology Quiz – Case 4

Pneumonology Quiz – Case 4 (free article from Archives of Hellenic Medicine)

Dear friends read new Pneumology Quiz from Archives of Hellenic Medicine!

A 34-year-old female patient presented to the emergency department with 6 hours’ history of sudden onset of breathlessness associated with severe pleuritic chest pain, minimal hemoptysis and pyrexia. She denied any other symptoms. She
had only returned from a business meeting in South Africa a week ago and she was quite concerned of the possibility of having contracted a tropical infection, although she had followed vaccination and hygiene advice given by an infectious disease specialist before her departure, four weeks ago. Her past medical history included two episodes of miscarriage. On examination, she was tachycardic (95 bpm) with normal blood pressure (140/75 mmHg), tachypneic (22 bpm) with normal oxygen saturation (95% on room air) and pyrexial (37.4 oC). A detailed clinical examination did not yield positive clinical findings. Full blood count, urea and electrolytes, as well as c-reactive protein (CRP) were all within normal range. Chest X-ray was insignificant.

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Previous cases:

Pneumonology Quiz - Case 1

Pneumonology Quiz - Case 2

Pneumonology Quiz – Case 3