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(Lung Pathology) No rest for the weary: An 80-year-old man presents to the clinic for evaluation of shortness of breath and chest pain. (Whenever they say "chest pain", it is VERY serious). The pain has been gradually progressive over the past 6 months and increases with inspiration, which he describes as "sharp and stabbing." He has had a nonproductive cough during the same time and denies any smoking history. He retired 7 years ago after working with ASBESTOS for more than 50 years. On physical examination, his blood pressure is 160/90 mm Hg, pulse is 90/min, and respirations are 25/min. There is clubbing of the fingernail beds, and he appears mildly cyanotic. On a lung examination, there are end inspiratory dry rales bilaterally with reduced breath sounds. Pulmonary function tests reveal a decreased forced expiratory volume in 1 second (FEV1) and a decreased forced vital capacity (FVC), but the ratio was normal. Total lung capacity is reduced. A chest x-ray film reveals diffuse bilateral interstitial fibrosis and calcifications at both pleural bases. Which of the following is the most likely diagnosis? 1-Idiopathic interstitial fibrosis 2-Asbestosis 3-Legionella pneumonia 4-Pneumocystis carinii pneumonia 5-Tuberculosis 6-Mycoplasma 7-Viral etiology

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Subject: Tommy's Concepts

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(Lung Pathology)


No rest for the weary: An 80-year-old man presents to the clinic for evaluation of shortness of breath and chest pain. (Whenever they say "chest pain", it is VERY serious). The pain has been gradually progressive over the past 6 months and increases with inspiration, which he describes as "sharp and stabbing." He has had a nonproductive cough during the same time and denies any smoking history. He retired 7 years ago after working with ASBESTOS for more than 50 years. On physical examination, his blood pressure is 160/90 mm Hg, pulse is 90/min, and respirations are 25/min. There is clubbing of the fingernail beds, and he appears mildly cyanotic. On a lung examination, there are end inspiratory dry rales bilaterally with reduced breath sounds. Pulmonary function tests reveal a decreased forced expiratory volume in 1 second (FEV1) and a decreased forced vital capacity (FVC), but the ratio was normal. Total lung capacity is reduced. A chest x-ray film reveals diffuse bilateral interstitial fibrosis and calcifications at both pleural bases. Which of the following is the most likely diagnosis?
1-Idiopathic interstitial fibrosis
2-Asbestosis
3-Legionella pneumonia
4-Pneumocystis carinii pneumonia
5-Tuberculosis
6-Mycoplasma
7-Viral etiology

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