A 64-year-old female presents with complaint of chronic prod…

A 64-year-old female presents with complaint of chronic productive cough for the last 4 months. She states that she has had periods of similar symptoms over the past several years, which typically last for 3-4 months. She has a 40-pack-year history of cigarette use. The patient denies any fevers, reporting only occasional shortness of breath and a persistent cough where she frequently expectorates thick, white sputum. Vital signs are as follows: T 98.6F,  HR 88/min, BP 136/88, RR 18/min, O2 sat 94% (room air). Physical exam is significant for bilateral end-expiratory wheezes, a blue tint to the patient’s lips and mucous membranes of the mouth, and a barrel chest. Which of the following conditions is the most likely diagnosis for this patient?

A 64-year-old male presents to the Emergency Department with…

A 64-year-old male presents to the Emergency Department with the sudden onset of chest pain and shortness of breath. The pain is worse on deep inspiration. He denies any fevers, chills, or cough. He has no significant past medical history. He takes no medications and is allergic to contrast dye. He drives trucks for a living and just completed an 18-hour trip. Vital signs include Temp:98.6 F, BP: 120/70 mmHg, HR: 112/min, and RR: 20/min. On physical exam, the patient is overweight and tachypneic. His lungs are clear to auscultation and cardiac exam is significant for tachycardia. His abdominal exam is within normal limits. The circumference of his right calf is 3 cm greater than his left calf. Initial EKG is obtained (see image below).                  Which of the following findings would be expected on ventilation/perfusion (V/Q) scan?