A 56-Year-Old Man Is Evaluated for Dyspnea and Chest Discomfort

A 56-year-old man is evaluated for dyspnea and chest discomfort.  Medical history includes hypertension, type 2 diabetes mellitus, and chronic kidney disease.  Temperature is 37.8 C (100 F) , blood pressure is 160/90 mm Hg, pulse is 98/min, and respirations are 24/min.  BMI is 31 kg/m².  The patient undergoes a 2-part nuclear medicine test.  During the first part, he breathes in a radioactive tracer and a lung scan is performed.  In the second part of the test, he is given an intravenous injection of a different radioactive material while breathing normal air, and the scan is repeated.  When the images are compared, a large area of the lower right lung is not visualized in the second scan.  Based on the observed findings, which of the following underlying disease processes is most likely present in this patient?

A) Deep venous thrombosis
B) Endobronchial neoplasm
C) Left ventricular infarction
D) Spontaneous pneumothorax
E) Viral pleuritis with effusion

Correct Answer:

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