You are performing a breast exam on an adult woman. You are inspecting the breasts for signs of retraction. What is the best position to observe for this?

A. Often referred to as "pigeon chest," pectus carinatum is a condition where the chest protrudes outward. This deformity makes the chest appear to bulge forward, giving it a distinctive "pigeon-like" appearance.
B. Barrel chest is characterized by an increased anteroposterior (AP) diameter of the chest, giving it a rounded, barrel-like appearance. This can occur due to conditions such as chronic obstructive pulmonary disease (COPD) or emphysema.
C. Scoliosis is a lateral curvature of the spine, which can cause a noticeable asymmetry in the rib cage and back. It often presents as a side-to-side curve in the spine, which can lead to an uneven shoulder height and a visibly curved back when viewed from the side.
D. Known as "funnel chest," pectus excavatum is a condition where the breastbone (sternum) is sunken into the chest. This causes a noticeable depression in the middle of the chest and may appear as a concave or hollowed area.

A. Atelectasis refers to the collapse or incomplete expansion of a lung or a portion of a lung. It can cause decreased breath sounds and dullness upon percussion, but it is less likely to present with a fever as high as 102.1°F. However, atelectasis can occur secondary to an obstructive pneumonia, making the distinction important in clinical settings.
B. Pulmonary obstruction, such as from an obstruction of the airway or bronchus, might cause symptoms like difficulty breathing and decreased oxygen saturation. However, it would less commonly present with fever and localized crackles.
C. Pneumonia often presents with symptoms such as fever (elevated temperature of 102.1°F), increased respiratory rate (30 breaths per minute), decreased oxygen saturation (90% on room air), and abnormal lung findings. The decreased expansion and dullness over the right lung, along with crackles (rales) heard in the right lower lobe, are indicative of fluid accumulation and inflammation in the lung, which are characteristic of pneumonia.
D. Acute bronchitis involves inflammation of the bronchi and is often associated with a cough, sputum production, and sometimes fever. However, it typically presents with a productive cough and wheezing rather than localized dullness and crackles confined to one lobe.