OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is pulmonary edema. While this may seem a odd practice, it is useful to see multiple examples of how pulmonary edema will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
QUESTION EXAMPLES
Question # 1
A 75 year old woman is brought to the hospital because she has been feeling chest tightness, shortness of breath, orthopnea, and paroxysmal nocturnal dyspnea for the past day. Her past medical history is notable for a diagnosis of type 2 diabetes and coronary artery disease. She currently is taking metformin, atenolol, and aspirin daily. The patient notably has difficulty speaking during the interview because of her respiratory distress. Her heart rate is 104/min, respirations are 27/min, and her blood pressure is 170/100 mm Hg. Physical exam is notable for jugular venus distention when the patient is sitting upright, and crackles are heard at both lung bases. A cardiac exam also reveals the presence of an S3 gallop. An arterial blood gas analysis is collected while the patient is on 40% oxygen and the results are shown below:
- pH: 7.49
- pCO2: 31 mm Hg
- pO2: 100 mm Hg
A portable chest X-ray reveals the presence of bilateral interstitial and alveolar infiltrates. What is the likely cause of dyspnea in this patient?
Question # 2
A 60 year old male comes to the clinic because he has been experiencing shortness of breath for the past 3 days. He also has swelling of his lower legs since he returned from a 300 mile car trip. His past medical history is notable for a 20 year history of poorly controlled hypertension that has been treated with a thiazide diuretic. His temperature is 98.8°F, pulse is 100/min, respiration are 25/min, and blood pressure is 170/105 mm Hg. A physical exam reveals jugular venous distention and crackles at the lower lung fields bilaterally. A prominent S3 heart sound is heard upon auscultating the heart. There is 4 + lower leg edema that reaches the ankles. A chest X-ray is conducted and is remarkable for cardiomegaly and cephalization of the pulmonary vessels. What is the likely diagnosis?
Page Updated: 01.22.2017