A 65-year-old man who has a lengthy history of smoking visits the emergency room complaining of chronic moderate cough and shortness of breath. Over the past week, his symptoms progressively worsened, but today they abruptly got worse. The patient has hypertension that is treated with hydrochlorothiazide. His temperature is 36.7 C (98 F) during examination, and his blood pressure, pulse, and respirations are 135/85 mm Hg and 94/min, respectively. On room air, pulse oximetry displays 86 percent. There are less breath noises coming from his right chest. The picture below shows an x-ray of his chest. Which of the following is the most likely cause of this patient's radiographic findings?

Question

A 65-year-old man who has a lengthy history of smoking visits the emergency room complaining of chronic moderate cough and shortness of breath. Over the past week, his symptoms progressively worsened, but today they abruptly got worse. The patient has hypertension that is treated with hydrochlorothiazide. His temperature is 36.7 C (98 F) during examination, and his blood pressure, pulse, and respirations are 135/85 mm Hg and 94/min, respectively. On room air, pulse oximetry displays 86 percent. There are less breath noises coming from his right chest. The picture below shows an x-ray of his chest.  Which of the following is the most likely cause of this patient's radiographic findings?

Quizplus · Accepted Answer

Eductional Objective: Obstructive atelectasis and full lung collapse can result from an obstructive lesion in a mainstem bronchus, which prevents ventilation of the entire lung. Unilateral pulmonary opacification and mediastinum displacement toward the opacified lung are distinguishing chest x-ray features.

A 65-Year-Old Man Who Has a Lengthy History of Smoking