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171821 Radiology

A 34-year-old female cab driver, a smoker, is admitted with acute shoness of breath and mild hemoptysis. Her review of systems is otherwise unremarkable. Physical examination: pulse 100 bpm; temperature 99degF; respirations 21/min; blood pressure 160/84 mm Hg. The patient is overweight with a BMI of 30. Other peinent findings: lungs have decreased breath sounds with crackles in both bases. Hea: NSR with loud P2 and grade 2/6 systolic murmur in the left parasternal area. Extremities reveal trace bilateral pedal edema. Laboratory data: Hb 15 g/dL; Hct 45%; WBCs 7.0/uL. EKG shows mild LV strain with no acute current of injury. ABGs on room air: pH 7.38; PCO2 45 mm Hg; PO2 70 mm Hg. CXR is shown in . The likely diagnosis is

AMycoplasma/atypical pneumonia
BObstructive sleep apnea
CChronic bronchitis
DPulmonary embolism
Radiology
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