PATHOLOGIC QUIZ CASE 1
Robert M. Naclerio, MD, Houston
A 72-year-old woman had a six-week history of respiratory distress manifested by dyspnea, wheezing, and cough. Her medical history was unremarkable for cardiac or pulmonary disease.Physical examination demonstrated an elderly woman in moderate respiratory distress. Her vital signs were a respiratory rate of 28/min, a blood pressure of 110/70 mm Hg, a pulse rate of 100 beats per minute, and a temperature of 37 °C. Inspiratory stridor and both inspiratory and expiratory wheezing dominated the pulmonary examination. The results of the remainder of the physical examination were within normal limits.Arterial blood gases while breathing room air were pH of 7.44, Pco2 of 26 mm Hg, and Pao2 of 78 mm Hg. Chest roentgenogram showed neither cardiomegaly nor pulmonic infiltrate. Electrocardiogram demonstrated a right bundle-branch block without evidence of acute change.The patient was admitted to the hospital.
ROBERT E FECHNER. Resident's Page. Arch Otolaryngol. 1980;106(8):514–517. doi:10.1001/archotol.1980.00790320066018