A 5-year-old girl had a sudden attack of suffocating cough accompanied by wheezing. There was no fever but the child appeared anxious and in distress. What is the most likely diagnosis?

A 75-year-old woman with a recent history of myocardial infarction develops hemopericardium and expires. At autopsy. multiple wedge-shaped lesions are observed on the surface of the patient's spleen (shown). These pale infarcts were most likely caused by thromboemboli originating in which of the following anatomic locations?

A 69-year-old man Is brought to be Emergency Department because of the sudden-onset of left-sided chest pain that is exacerbated upon inspiration. Physical examination reveals dyspnea and hemoptysis. His temperature is 38’C (101”F), pulse is 110/min. respirations are 35/min. and blood pressure is 158/100 mm Hg. A lateral chest wall friction rub is present on auscultation. The left leg Is markedly edematous. A chest x-ray reveals a left pleural effusion. What is the most likely cause of this patient” s left-sided chest pain, pleural effusion. dyspnea, and hemoptysis?

A 64-year-old woman with bilateral. varicose veins of her legs developed sudden onset\ chest pain. and expectorated blood the next day (hemoptysis). What could have caused the patient’s symptoms?

A 62-year-old woman suffers internal Injuries in an automobile accident and appears to be in a state of shock. Two days later, the patient develops rapidly progressive respiratory distress and a pattern of “’interstitial pneumonia” on chest x-ray (shock lung). Which of the following pathologic findings could be expected in the lungs of this patient with diffuse alveolar carriage?

A 65-year-old woman is diagnosed who "angina pectoris”. What causes this condition?

A 20-year-old man from China is evaluated for persistent cough, night sweats, low-grade fever, and general malaise. An x-ray film of the chest reveals findings that are described as "consistent with a Ghon complex". Sputum cultures grow acid-fast bacilli. Biopsy of a hilar lymph node in this patient would most likely demonstrate which of the following morphological patterns of necrosis?

A 22-year-old construction worker falls 30 feet and fractures several bones, including his left femoral shaft. Six hours later, the patient develops shortness of breath and cyanosis. Which of the following hemodynamic disorders best explains the pathogenesis of respiratory distress in this patient?

Alcoholism is the single most common predisposing condition for the development of which of the following pulmonary diseases?

A sputum sample obtained from a 68-year-old former construction worker reveals needle-like inert minerals (shown). This patient is at increased risk of developing which of the following malignant neoplasms?

A 35-year-old man was salvaged from a burning house. Because of marked shortness of breath, he was placed on a ventilator. What is the underlying cause of dyspnea in this patient?

A 65-year-old woman experienced chest pain on exertion that was relieved by taking nitroglycerin. What is the appropriate name for this patient's chest pain?

A 39-year-old man with AIDS is admitted to the hospital with a 3-week history of chest pain and shortness of breath. An x-ray film of the chest shows bilateral nodularities of the lungs. A CT-guided lung biopsy reveals granulomatous inflammation with scattered multinucleated giant cells. Giant cells in these pulmonary lesions are derived from which of the following inflammatory cells?

A 65-year-old patient with a history of systemic hypertension suddenly develops acute chest pain that extends towards the abdominal cavity. This episode is quickly followed by a drop in blood pressure (hypotension). This patient has most likely suffered which of the following medical emergencies?

A 55-year-old stone worker presents with a 5-year history of increasing shortness of breath. Chronic inhalation of quartz (silicon dioxide) in this patient most likely caused which of the following lung diseases?

A 70-year-old male is admitted after a massive anterior myocardial infarction and initially stabilizes with medical management. Several days later, he suddenly develops ventricular tachycardia followed by cardiac arrest. Histologic remodeling of the infarcted myocardium reveals fibroblast infiltration with deposition of type I collagen, replacing large numbers of necrotic cardiac myocytes. Which of the following best explains the principal cause of death in patients following a massive myocardial infarction?

A 59-year-old man with a history of poor dentition presents with fever, new-onset heart murmur, and positive blood cultures for Streptococcus species. The provider suspects infective endocarditis involving a native heart valve. Which pathophysiologic characteristic of cardiac valves most explains why bacteria are able to adhere and proliferate in this location?

Autopsy of an 80-year-old woman with a history of congestive heart failure reveals marked enlargement of the left ventricle. Which of the following mechanisms of disease is most likely responsible for this autopsy finding?

A 72-year-old woman is admitted with sudden hypotension, chest pain, and syncope five days after an anterior ST-elevation myocardial infarction treated medically. She rapidly deteriorates and develops signs of cardiogenic shock. The provider suspects free-wall myocardial rupture. Which of the following best explains the pathophysiologic mechanism responsible for this complication?

A 67-year-old woman with a history of diabetes, systemic hypertension and recent myocardial infarction suddenly develops gangrene of her left toe. The patient's vital signs are unremarkable. Blood cultures are negative. What is the most likely cause of necrosis in this patient?

A 48-year-old man with a history of heavy smoking presents with a 3-year history of persistent cough and frequent upper respiratory infections, associated with sputum production. Analysis of arterial blood gases reveals hypoxia and CO2 retention. Which of the following is the appropriate diagnosis?

A 67-year-old smoker with long-standing bronchitis expectorates blood during a paroxysm of coughing. What is a possible serious cause of hemoptysis in this patient that should be considered?

A 58-year-old woman visits your clinic. She had a radical mastectomy and axillary node dissection for breast cancer two years ago. She now notices that her arm becomes swollen by the end of the day. What is the appropriate name for this soft tissue fluid accumulation?

A 16-year-old boy is rushed to the emergency room after sustaining a stab wound to the chest during a fight. Physical examination reveals a 1-inch entry wound at the right 5th Intercostal space in the mid-clavicular line. Chest x-ray reveals air in the right pleural space. Which of the following is an expected complication of pneumothorax in this patient?