A patient has pleural effusion with empyema. The following are clinical manifestations except:
Bradycardia
Pleural pain
Cough
Fever
The Correct Answer is A
A. Bradycardia: Bradycardia, which is a slower than normal heart rate, is not a typical clinical manifestation of pleural effusion with empyema. In fact, fever and infection usually lead to tachycardia (an increased heart rate) as the body attempts to respond to infection.
B. Pleural pain: Pleural pain is a common symptom associated with pleural effusion and empyema, resulting from irritation of the pleura due to inflammation or infection.
C. Cough: A cough can occur with pleural effusion and empyema, often as a response to irritation or pressure in the thoracic cavity. It may also be associated with underlying lung conditions contributing to the effusion.
D. Fever: Fever is a typical clinical manifestation of empyema, indicating an infectious process. The presence of infection in the pleural space often results in systemic signs of infection, such as fever.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. It does not remain dormant but some host defenses can kill the bacteria: While the immune system can kill some of the Mycobacterium tuberculosis bacilli, in many cases, the bacteria evade complete eradication and persist in a dormant state within the lungs. This does not mean the infection is fully eliminated, as it can reactivate later.
B. Virulence factors in the bacilli weaken over time, leading to apoptosis: Mycobacterium tuberculosis does not naturally lose its virulence over time. Instead, it can persist in a latent state due to immune containment, not because of a reduction in its ability to cause disease.
C. The bacilli can become isolated within tubercles in the lungs, possibly encapsulated: In latent tuberculosis, the immune system walls off the bacilli within granulomas (tubercles), preventing active disease. These granulomas may be encapsulated with fibrous tissue, restricting bacterial growth and spread. The bacteria remain dormant but can reactivate if the immune system weakens.
D. Macrophages attack and phagocytize new areas of infection: While macrophages do play a role in the immune response to tuberculosis, they are often unable to completely eradicate the bacilli. Instead, the bacteria can survive within macrophages and trigger the formation of granulomas, which help contain but not eliminate the infection.
Correct Answer is C
Explanation
A. Atherosclerotic lesion: An atherosclerotic lesion can lead to reduced blood flow to the myocardium, but it is not the direct trigger for angina pectoris. Rather, it is a contributing factor to the development of conditions that cause angina.
B. Myocardial necrosis: Myocardial necrosis refers to irreversible cell damage due to prolonged ischemia, such as in a myocardial infarction. This is not a trigger for angina pectoris but rather a consequence of severe and prolonged ischemia.
C. Myocardial ischemia: Myocardial ischemia is the primary trigger for angina pectoris. It occurs when there is an imbalance between the oxygen supply and demand in the heart muscle, typically due to narrowed coronary arteries. This insufficient blood flow results in chest pain or discomfort characteristic of angina.
D. Hyperlipidemia: Hyperlipidemia is a risk factor for atherosclerosis and subsequent coronary artery disease but does not directly trigger angina pectoris. It contributes to the underlying processes that lead to myocardial ischemia.
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