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Review of Clinical Signs Review Questions

Acute Dyspnea: A Sign of Underlying Disease

Authors: Michael C. Boyars, MD
Bernard Karnath MD
Anita C. Mercado, MD


1. A 50-year-old man presents with a complaint of dyspnea on exertion with associated chest pain. He describes the chest pain as a substernal, pressure-like sensation that is alleviated with rest. What is the most likely etiology of this patient’s dyspnea?
  1. Asthma
  2. Ischemic heart disease
  3. Pneumothorax
  4. Pulmonary embolism
Click here to compare your answer.


2. A 40-year-old woman presents with the complaint of dyspnea that was acute in onset. She also noticed some right leg edema and calf tenderness yesterday. Physical examination reveals normal vesicular breath sounds in both lung fields. What is the most likely etiology of this patient’s dyspnea?

  1. Asthma
  2. Ischemic heart disease
  3. Pneumothorax
  4. Pulmonary embolism
Click here to compare your answer.


3. A 65-year-old woman presents a 5-day history of fever and dyspnea and a cough that is productive of rust-colored sputum. She also reports some right-sided chest pain that worsens with deep inspiration. Physical examination reveals bronchial breath sounds with some inspiratory crackles in the right lower lung fields. What is the most likely etiology of this patient’s dyspnea?

  1. Asthma
  2. Ischemic heart disease
  3. Pneumonia
  4. Pulmonary embolism
Click here to compare your answer.


4. A 70-year-old woman presents with dyspnea on exertion and associated chest pain. She describes the chest pain as a substernal, pressure-like sensation that is alleviated with rest. Physical examination reveals a loud systolic murmur heard best at the right upper sternal border that radiates into the carotid region bilaterally. Her carotid pulses are diminished. Her left ventricular impulse is dilated and sustained. What is the most likely etiology of this patient’s dyspnea?
  1. Asthma
  2. Valvular heart disease
  3. Pericarditis
  4. Pulmonary embolism
Click here to compare your answer.


5. A 50-year-old man presents with the complaint of dyspnea on exertion. He denies any associated chest pain. He has a history of smoking 2 packs of cigarettes per day for the past 30 years. Physical examination reveals diffuse expiratory wheezes heard in all lung fields. What is the most likely etiology of this patient’s dyspnea?

  1. Chronic obstructive pulmonary disease (COPD)
  2. Ischemic heart disease
  3. Pneumothorax
  4. Pulmonary embolism
Click here to compare your answer.



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