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| A 9-year old child of unemployed parents presents with shortness of breath that is worse on exertion. On examination, there is marked pallor of the mucous membranes. CBC shows low hemoglobin and hematocrit. His MCV and MCHC are both low. His WBC and platelets are normal. |
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| Anemia-most likely iron deficiency anemia |
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| A 6-year old child presents with recurrent bouts of shortness of breath and wheezing. There is a family of hay fever. On examination, her respiratory rate is 28/minute. Her accessory muscles of respiration are in use and there are scattered expiratory wheezes heard throughout the lungs. A chest x-ray shows hyperinflation of both lung fields and the CBC shows marked eosinophilia. |
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| A 55-year old female smoker presents with fever and a cough which is productive. She has been smoking a pack of cigarettes a day for the past 15 years. She has had the cough and shortness of breath on and off for the past 4 months. She has had a similar episode last year also. On examination, there is central cyanosis and there are bilateral wheezes and crackles. There is also mild pitting edema in both legs. CBC shows a WBC count of 12,000 and an elevated neutrophil count. The chest x-ray does not show any masses, infiltrates or consolidation. |
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| A 63-year old male presents with dyspnea worse with exertion. He also complains of swollen ankles, orthopnea and paroxysmal nocturnal dyspnea. On examination, there is jugular venous distension, bilateral basal crackles, peripheral edema and a positive hepatojugular reflex. PA chest x-ray shows cardiomegaly, prominent pulmonary vasculature and Kerley B lines. |
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| A thin 19-year old male presents with shortness of breath. He also has polyuria, polydypsia and polyphagia. On examination, there is a fruity smell to his breath. Urinalysis shows the presence of ketones. The CMP show hyperglycemia, hypokalemia and metabolic acidosis. |
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| A thin 53-year old male smoker presents with dyspnea on exertion and a dry cough. There is no fever or chest pain. On examination, he has a barrel chest with hyperresonant percussion notes and decreased breath sounds bilaterally. Chest x-ray shows a thin mediastinum and a flattened diaphragm. |
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| A 53-year old female diabetic presents with sudden onset of shortness of breath after a heavy meal. She has been on insulin for the past three years. On examination, she is sweating and her pulse is irregular. ECG shows ST elevation and pathological Q waves. Troponin I and CK-MB are both elevated. Her HbA1C is 8. |
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| A 26-year old female presents with sudden attacks of shortness of breath accompanied with intense fear of dying and the fear of losing control. She also complains of palpitations, a choking sensation and numbness in her fingers. On examination, her BO is normal. Her pulse rate is 86/minute and it is regular. There is no goiter nor exophthalmos. What is the most likely diagnosis? |
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| A 25-year old male migrant worker presents with shortness of breath following a fever and cough which he has had for the past two weeks. On examination, there is stony dull percussion note over the base of the right lung. The tactile fremitus over this area is decreased. Breath sounds are also diminished and there is both egophony and whispered pectoriloquy just above the area of dullness. CBC shows a leukocytosis and lymphocytosis. Chest x-ray reveals obliteration of the right costophrenic angle. |
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| A 78-year old male presents with chills, fever, pleuritic chest pain, a cough with rust-colored sputum. On examination, the percussion note is decreased on the lower left side of the chest and there is bronchial breathing present over the same area. CBC shows marked elevation of his neutrophils and a leukocytosis. Chest x-ray shows consolidation in the lower lobe on the left side. |
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| A 76-year old female presents with sudden onset of shortness of breath, sticking chest pain and hemoptysis four days after undergoing a hip replacement. She has been diagnosed with osteoporosis for the past 10 years. She slipped and fell in the supermarket recently and broke her hip. On examination, her right leg is warm, swollen and tender. |
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| A 33-year old female presents with insidious onset of shortness of breath. She also complains of painful bumps on both of her legs. On examination, there are several red painful swollen areas over the anterior aspects of both legs. CBC shows a leukopenia. CMP shows hypercalcemia and her chest x-ray reveals bilateral hilar lymphadenopathy. |
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| A 23-year old male presents with sudden onset of shortness of breath shortly after being stabbed in the chest this morning. On examination, his respiratory rate is 28/minute. Breath sounds are absent over the entire right side of the chest. The trachea is deviated to the left and there is cyanosis. Chest x-ray shows a collapsed right lung with a mediastinal shift to the left. |
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| A 49-year old homeless male presents with progressive shortness of breath, fever, night sweats and hemoptysis. On examination, there is bronchial breathing in the apex of the left lung and there is clubbing of the fingers of both hands. Chest x-ray reveals left apical consolidation with several large cavities. Examination of his sputum reveals several bacilli when stained with the Ziehl-Neelsen method. The Lowenstein Jensen culture results are pending. |
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