A 79-year-old female who is 7 days post total hip arthroplasty develops sudden onset of dyspnea, cough, and retrosternal chest pain. On examination, she appears anxious with vital signs as follows: pulse 120, respirations 32, and blood pressure 138/92 mm Hg. A chest x-ray demonstrates mild bilateral atelectasis. Her electrocardiogram (ECG) is normal. What is the imaging modality of choice for confirmation of the suspected diagnosis?

(A)          Computed tomography (CT) pulmonary angiography

(B)          Contrast venography

(C)          Doppler ultrasound

(D)          Pulmonary magnetic resonance imaging (MRI) with IV contrast

(E)          Ventilation–perfusion (V/Q) scan

A 30-year-old male presents to the emergency department after being rescued from a house fire. The patient complains of a headache, fatigue, confusion, nausea, vomiting, and some shortness of breath. Pulse oximetry is 93% on room air, and his respirations are 18/min. His carboxyhemoglobin (COHb) level is 23% (normal

(A)          100% oxygen via nonrebreather mask

(B)          β2-adrenergic agonists

(C)          Hyperbaric oxygen

(D)          Nebulized epinephrine

(E)          Intravenous solumedrol

A 45-year-old male with a 22-pack-year smoking history presents to the office for evaluation of ongoing productive cough. The cough has persisted for the past 3 months. He has had similar episodes in the spring and fall of every year for the past 4 years. The sputum has a yellowish color, but no blood. On physical examination, the patient’s BMI is 33, his blood pressure is 152/92 mm Hg, his heart rate is 90 beats/min, and his respiratory rate is 17 breaths/min. He has a prolonged expiratory phase, and his lips appear slightly cyanotic. Which of the following anatomical or histological findings are consistent with his most likely diagnosis?

(A)          Dilated bronchioles with fibrosis and thick intraluminal material

(B)          Dilation of air spaces with destruction of the alveolar walls

(C)          Mucous gland hyperplasia

(D)          Presence of neutrophils in the alveoli

(E)          Smooth muscle hypertrophy with an eosinophilic infiltrate