Which of the following patients who presented to a walk-in medical clinic is most likely to be diagnosed wtih a rhinosinusitis rather than a common cold?

A woman presenting with malaise, lethargy, and copious nasal secretions

A man with a dry, stuffy nasopharynx, a sore throat, and temperature of 98.9°F

A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9°F

A woman complaining of generalized aches and who has a hoarse voice and reddened, painful upper airways

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is A

Explanation

A. Obstructive: Obstructive pulmonary disease is characterized by increased resistance in the airways, making it more difficult to expire air. Conditions such as asthma and chronic obstructive pulmonary disease (COPD) lead to airflow limitation, requiring greater force to expel air from the lungs.

B. Communicable: Communicable pulmonary diseases refer to infections that can be transmitted from person to person, such as tuberculosis or influenza. This classification does not directly relate to the mechanics of airflow and does not specifically require more force to expire air.

C. Acute: Acute pulmonary disease describes a sudden onset of symptoms, which can be caused by various conditions (e.g., pneumonia or pulmonary embolism). The term "acute" does not inherently indicate a need for increased expiratory force and can encompass both obstructive and restrictive patterns.

D. Restrictive: Restrictive pulmonary disease involves reduced lung volume and compliance, making it difficult to expand the lungs fully during inspiration. While patients may struggle to inhale adequately, they typically do not require increased force to expire air, as expiratory airflow is usually not obstructed in the same manner as in obstructive diseases.

A. "Actually, people who have the latent form of the disease won't be sick and can't spread it either." B. "Many people do manage to fight off the infection, but you are right: they can still spread it by coughing or sneezing." C. "There isn't any real risk of them spreading it, but we would like to vaccinate everyone who's had any contact with it in the past." D. "If someone has been previously exposed to tuberculosis, they are particularly infectious because they are often unaware of the disease."

Correct Answer is A

Explanation

A. Actually, people who have the latent form of the disease won't be sick and can't spread it either: This response is accurate because individuals with latent tuberculosis infection (LTBI) do not exhibit symptoms and are not infectious. They carry the bacteria in their body, but it remains dormant and does not spread to others. Only those with active tuberculosis disease are capable of transmitting the infection through respiratory droplets.

B. Many people do manage to fight off the infection, but you are right: they can still spread it by coughing or sneezing: This statement is misleading because it implies that individuals with LTBI can spread the disease, which is not the case. Only those with active TB are contagious.

C. There isn't any real risk of them spreading it, but we would like to vaccinate everyone who's had any contact with it in the past: This response downplays the importance of understanding the difference between latent and active TB and could create confusion. Vaccination for tuberculosis (BCG vaccine) is not routinely given in the United States, and exposure alone does not necessitate vaccination.

D. If someone has been previously exposed to tuberculosis, they are particularly infectious because they are often unaware of the disease: This statement is incorrect, as individuals who have been exposed but have LTBI are not infectious. It is only those with active TB who pose a risk of spreading the infection.

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Which of the following patients who presented to a walk-in medical clinic is most likely to be diagnosed wtih a rhinosinusitis rather than a common cold?

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Which type of pulmonary disease requires more force to expire a volume of air?

Correct Answer is A

Explanation

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