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March 2017 Imaging Case of the Month

Courtney M. Tomblinson, MD and Michael B. Gotway, MD


Department of Radiology

Mayo Clinic Arizona

Scottsdale, Arizona USA


Imaging Case of the Month CME Information  

Members of the Arizona, New Mexico, Colorado and California Thoracic Societies and the Mayo Clinic are able to receive  0.25 AMA PRA Category 1 Credits™. Completion of an evaluation form is required to receive credit and a link is provided on the last panel of the activity.

0.25 AMA PRA Category 1 Credit(s)™

Estimated time to complete this activity: 0.25 hours

Lead Author(s): Courtney M. Tomblinson, MD. All Faculty, CME Planning Committee Members, and the CME Office Reviewers have disclosed that they do not have any relevant financial relationships with commercial interests that would constitute a conflict of interest concerning this CME activity. 

Learning Objectives:
As a result of this activity I will be better able to:    

  1. Correctly interpret and identify clinical practices supported by the highest quality available evidence.
  2. Will be better able to establsh the optimal evaluation leading to a correct diagnosis for patients with pulmonary, critical care and sleep disorders.
  3. Will improve the translation of the most current clinical information into the delivery of high quality care for patients.
  4. Will integrate new treatment options in discussing available treatment alternatives for patients with pulmonary, critical care and sleep related disorders.

Learning Format: Case-based, interactive online course, including mandatory assessment questions (number of questions varies by case). Please also read the Technical Requirements.

CME Sponsor: University of Arizona College of Medicine at the Arizona Health Sciences Center.

Current Approval Period: January 1, 2015-December 31, 2017


Clinical History: A 69-year-old man presented with long-standing complaints of dyspnea, progressing to dyspnea at rest, associated with some dysphagia to solids. He also noted symptoms consistent with exertional stertor (a respiratory sound characterized by heavy snoring or gasping). His past medical history was remarkable only for hypertension controlled with medication.

Laboratory data, include white blood cell count, coagulation profile, and serum chemistries were within normal limits. Oxygen saturation on room air was normal.

Frontal chest radiography (Figure 1) was performed.

Figure 1: Frontal chest radiography.

Which of the following statements regarding the chest radiograph is most accurate? (Click on the correct answer to proceed to the second of nine pages)

  1. Frontal chest radiography shows a cavitary lung mass
  2. Frontal chest radiography shows an abnormal mediastinal contour
  3. Frontal chest radiography shows multiple small nodules
  4. Frontal chest radiography shows peribronchial and mediastinal lymphadenopathy
  5. Frontal chest radiography shows pleural effusion

Cite as: Tomblinson CM, Gotway MB. March 2017 imaging case of the month. Southwest J Pulm Crit Care. 2017;14(3):104-16. doi: https://doi.org/10.13175/swjpcc029-17 PDF 

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