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Chest imaging quiz- Clinical case scenarios

1. Case 1
A 13-year-old male patient with a recent road traffic accident presents, along with a hairline fracture of the anterior ribs, femur, ulna and radius. On further imaging, he was found to have a ruptured spleen along with an unidentifiable source of internal bleeding. The following day, he developed hydrocephalus which was managed with an intracranial drain. On Auscultation, a “crunch” was heard simultaneously with every heartbeat.



Question: What is the diagnosis of this patient in which corresponds with the auscultation findings?
  *This question is required.
2. Case 2:
A 36-year-old male patient presented with a history of tuberculosis 5 years ago with pleural effusion over the left middle lobe of the lung during the previous admission. He underwent pleural tapping for the same with an intercostal drain. He now presents with pain while deep inspiration and a decrease in exercise capacity. Sputum Acid-fast bacilli was negative. PFT showed an unusual increase in FEV1/FVC ratio of >90%. On percussion, a dull note is heard over the left side of the lung, with decreased breath sounds heard on auscultation. 



Question: What is the diagnosis? *This question is required.
3. Case 3:
A 22-year-old male patient came with chlorhexidine poisoning with chest X-ray changes. He had a history of frequent episodes of pneumonia in his childhood from 6 months of age until 5 years. Presently, he complains of inspiratory chest pain and decrease in lung capacity with breathlessness on exertion. He mentions that he gets seasonal bouts of tonsillitis every winter along with severe lower respiratory tract infection which usually requires hospital admission. On percussion, there are scattered dull notes present all over the chest and auscultation reveals decreased breath sounds.



Question: What is the diagnosis of this patient? *This question is required.
4. Case 4:
A 40-year-old male patient presented with constant pain over the right side of the chest – anteriorly and posteriorly with frequent episodes of fever over the past 3-4 months. He reports that the pain increases whenever he yawns or breathes deeply. It also worsens during any activity. He has a recent history of pneumonia 4 months ago which was treated symptomatically during previous admission. He is an active smoker with a history of 10 pack years. On percussion a dull note is heard bilaterally. Auscultation reveals increased resonance of sound when the patients speaks also present bilaterally.



Question: What is the diagnosis of this patient? *This question is required.
5. Case 5:
A 19-year-old male patient who had a recent episode of a road traffic accident was brought to the hospital. He was under the influence of alcohol but was conscious. His breathing is shallow and fast with a respiratory rate of 35 cycles/min. The ECG shows an irregular heart rhythm along with tachycardia. On examination, there are bruises and contusion over his anterior chest along with peripheral cyanosis. The chest X-rays reveals mid-line trachea along with flat neck veins. Breath sounds are heard equally over both lung fields.



Question: What is the diagnosis of this patient? *This question is required.
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