USMLE Question of the Week

Evaluating Postoperative Shortness of Breath

In Episode 18 of Med School Question of the Week for USMLE, Alisa Khomutova, MedSchoolCoach expert tutor, answers this medical school question: One day after undergoing open ventral hernia repair, a 46-year-old male complains of shortness of breath. He has smoked one pack of cigarettes daily for 15 years. He does not drink alcohol. On physical exam, temperate is 100.3°F, pulse is 99/min, respirations are 21/min, and blood pressure is 126/72 mm Hg. He appears uncomfortable. Lung examination shows reduced breath sounds over the left lung base. Cardiac examination is benign. The surgical dressing over the lapaotomy site is c/d/i (clean dry intact). Bowel sounds are hypoactive. The calves appear symmetrical and homan sign is negative. His hemoglobin concentration is 12.1 g/gL, leukocyte count is 11,400/mm, and platelet count is 210,000/mm. An x-ray of the chest is supine position is shown. Labs are pending. Which of the following is the likely cause of this patient’s symptoms?
  • Pneumonia
  • Pleural Effusion
  • Atelectasis
  • Congestive Heart Failure
  • Pulmonary Embolism
  • COPD Exacerbation
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Alisa Khomutova

Alisa received her B.S. from University of California, Davis, and attended Oakland University William Beaumont School of Medicine. In 2020, she matched into Stony Brook Teaching Hospital practicing General Surgery for residency.

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