Which condition is a cause of an acquired murmur?

A. A woman presenting with malaise, lethargy, and copious nasal secretions: These symptoms are more indicative of a common cold or viral upper respiratory infection. While nasal secretions can occur in rhinosinusitis, the absence of facial pain or pressure suggests a cold rather than sinus involvement.

B. A man with a dry, stuffy nasopharynx, a sore throat, and temperature of 98.9°F: This presentation is typical of a common cold or upper respiratory infection. The symptoms of a dry, stuffy nasopharynx and sore throat are not specifically indicative of rhinosinusitis, which usually involves more pronounced nasal and facial symptoms.

C. A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9°F: This combination of symptoms strongly suggests rhinosinusitis. The presence of facial pain, headache, and fever indicates inflammation and infection of the sinuses, which is characteristic of rhinosinusitis rather than a common cold.

D. A woman complaining of generalized aches and who has a hoarse voice and reddened, painful upper airways: These symptoms align more closely with a viral upper respiratory infection or laryngitis. The absence of specific sinus-related symptoms such as facial pain or nasal obstruction makes rhinosinusitis less likely in this case.

A. Pus in the pleural space: This describes empyema, a condition in which infection leads to pus accumulation in the pleural space. Empyema is commonly associated with bacterial pneumonia, lung abscess, or thoracic surgery and requires drainage and antibiotic therapy. It does not cause the lung collapse seen in pneumothorax.

B. Collapse of small airways: While airway collapse can occur in conditions like bronchiolitis or atelectasis, it is not the defining feature of pneumothorax. Pneumothorax specifically involves air leaking into the pleural space, which disrupts the negative pressure necessary for lung expansion and results in partial or complete lung collapse.

C. Blood in the chest cavity: This describes hemothorax, a condition in which blood accumulates in the pleural space due to trauma, ruptured blood vessels, or certain medical conditions. Unlike pneumothorax, which involves air in the pleural space, hemothorax requires different management, including drainage with a chest tube and possible fluid resuscitation.

D. Air in the pleural space: Pneumothorax occurs when air enters the pleural space, causing a loss of negative pressure and leading to lung collapse. This can result from chest trauma, spontaneous rupture of alveoli, underlying lung disease, or mechanical ventilation. Symptoms may include sudden chest pain, dyspnea, and decreased breath sounds on the affected side.