Ashley Garrett, MD
Karen Swanson, DO
Mayo Clinic Arizona
Scottsdale, AZ USA
History of Present Illness
A 77-year-old woman presented with dyspnea on exertion which was progressive for several years. She remains active but is "winded" with vigorous exercise or altitude. She denied cough, orthopnea , paroxysmal nocturnal dyspnea, chest pain or a prior history of pulmonary infections.
Past Medical, Social and Family History
She has a history of a seizure disorder and fibromyalgia. She has never smoked or drank and has no history of occupational exposures. There was no family history of respiratory disease.
Her physical exam was unremarkable.
Topamax and alprazolam.
A chest radiograph was performed (Figure 1).
Figure 1. Initial chest radiography.
Which of the following describe the initial chest x-ray? (Click on the correct answer to proceed to the second of five panels)
- The chest x-ray is normal
- There is a left lower mass
- There is bronchial dilatation and edema
- There is hyperinflation
- Three is a retrocardiac left lower pneumonia