A 55 yeаr оld mаle with PMH оf HTN repоrts mаlaise and cough for 5 days. Patient is not sure if he has had any fever, but reports some chills. Patient reports the cough is slightly productive, but not sure of the sputum type. Patient reports he also has nasal congestion, which has improved somewhat. Patient reports the cough is keeping him up at night and his lower chest and abdominal muscles hurt with the cough. Patient also reports some shortness of breath with exertion, but denies exertional chest pain. Patient denies nausea, vomiting, diarrhea or leg swelling. On exam, patient is well developed overweight male, in no apparent distress. Trachea midline, no JVD. Chest expansion is symmetric, anterior:lat diameter is 2:1. On auscultation, lungs with rales in middle field of the Rt lung heard posteriorly, but no wheezing or rhonchi. S1 and S2 with no murmurs, rubs or gallops. No leg edema. The rest of the exam is unremarkable. VS: BP: 135/95 sitting Rt arm; HR: 105 bpm; R: 20 breath per minute; T: 100.7F oral; Pulse Ox: 95% on Room Air. Please provide a reading for the following image (same format as previously):
A 60 yeаr оld mаle with PMH оf HIV infectiоn for 20 yeаrs, HTN, COPD with 55 pack-year-history who quit 5 years ago repots malaise and cough for the last few months. Patient reports the cough is non-productive, started about 1 month ago as mild and has gradually worsened. Patient also reports weight loss of about 15 pounds without trying to lose any. Patient also denies fever, chills, nasal congestion, chest pain or leg swelling. On exam, patient is well developed male, in no apparent distress. Trachea midline. Chest expansion is symmetric, anterior:lat diameter is 2:1. On auscultation, lungs with no wheezing, rales or rhonchi. S1 and S2 with no murmurs, rubs or gallops. No leg edema. The rest of the exam is unremarkable. VS: BP: 125/80 sitting Rt arm; HR: 85 bpm; R: 18 breath per minute; T: 98.6F oral; Pulse Ox: 95% on Room Air. Please provide a reading for the following image (same format as previously):