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Retired NBME 27 Answers

nbme27/Block 1/Question#21 (reveal difficulty score)
A 60-year-old man comes to the physician ...
Pleural effusion ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—shak360(20)
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(F) Pleural effusion (correct)

Pleural effusion presents with

  • decreased breath sounds (fluid in the pleural cavity dampens the transmission of sound and mechanical waves)
  • dullness to percussion
  • decreased tactile fremitus

Note that in pleural effusion, these tests are all "dulled" or are all "decreased".

Pneumothorax presents with

  • decreased breath sounds
  • hyperresonance to percussion
  • decreased tactile fremitus

all on the affected side.

Lobar pneumonia (or a consolidated lung) presents with

  • decreased breath sounds
  • dullness to percussion
  • increased tactile fremitus because the consolidated lung is adjacent to the body wall
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drdoom  very nice! +1



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