Intensive Care Medicine (ICM) Practice Exam

What findings are most consistent with pneumonia during a pulmonary exam?

1. Pneumothorax

2. Pleural effusion

3. Pneumonia

4. Broken stethoscope

The correct answer is: Pneumonia

Pneumonia is an infection that inflames the air sacs in one or both lungs, and during a pulmonary exam, specific findings can indicate its presence. The most consistent findings associated with pneumonia include: - **Auscultation findings:** Patients may exhibit bronchial breath sounds, which are typically heard over the trachea, but when they are heard over areas of the lung where they don't normally occur, it suggests consolidation due to pneumonia. - **Dullness to percussion:** This indicates that the lung tissue has become consolidated, which is common in pneumonia. - **Increased tactile fremitus:** This occurs because the denser lung tissue transmits vibrations more effectively than air-filled spaces. - **Adventitious sounds:** The presence of crackles or rales may be noted as fluid accumulates in the alveoli due to infection. The other choices, while they represent conditions related to the lungs, do not directly indicate pneumonia. A pneumothorax refers to air in the pleural space, which leads to decreased breath sounds and hyper-resonance upon percussion. Pleural effusion results in dullness and decreased breath sounds, but it is not specific to pneumonia. A broken stethoscope is irrelevant for clinical findings related to