Before you read the answer, please review the original Mystery Quiz posted 11/9/17
Hayashi MD, Robert Smith MD
The answer to the Mystery Quiz is lung carcinoma. The location of the lesion is the superior segment of the right lower lobe which is dependent when the patient is supine. This location often …
Vivian Hayashi MD, Robert Smith MD
The patient is a 72 year old man who presented with an incidentally noted right mid-lung density on a chest radiograph. The patient was asymptomatic at the time and was begun on empiric treatment with moxifloxacin, then a course of amoxicillin-clavulanate for a presumed pneumonia …
Before you read the answer, please review the original Mystery Quiz posted 11/18/16.
Vivian Hayashi MD, Robert Smith MD
The answer to the mystery quiz is aspiration pneumonia. The CXR (Image 1) shows a total opacification of the right hemithorax. Importantly, the tracheal air column is deviated to the side of the opacification. …
Vivian Hayashi MD, Robert Smith MD
The patient is an 86 year old man who presented with weakness, lethargy and falls. His history was noteworthy for an episode of empyema nine years earlier that was managed with tube thoracostomy followed by decortication. Seven years prior to this admission, upper endoscopy revealed …
Vivian Hayashi MD, Robert Smith MD
The patient is an 86 year old man who presented with weakness, lethargy and falls. His history was noteworthy for an episode of empyema nine years earlier that was managed with tube thoracostomy followed by decortication. Seven years prior to this admission, upper endoscopy revealed …
Vivian Hayashi MD, Robert Smith MD
The answer to the mystery quiz is methicillin-resistant S. aureus (MRSA) pneumonia. The initial CXR (image 4) showed increased density in the area of the left hilum, hinting at a process in the superior segment of the left lower lobe. The next CXR …
Vivian Hayashi MD, Robert Smith MD
The patient is a 46 year old female who presented to the emergency room with breathlessness, productive cough, subjective fever, and myalgia for one week. Her history was notable for mild persistent asthma treated with tiotropium, mometasone, formoterol, and albuterol as needed. The patient …
Vivian Hayashi MD, Robert Smith MD
The answer to the mystery quiz is pleural effusions, specifically, bilateral subpulmonic effusions. The chest radiograph shows a number of findings: (1) the apparent diaphragm shadow is in fact fluid sandwiched between the undersurface of the lung and the actual diaphragm (Image 2a, arrow); (2) …