Kettering TMC Practice Exam 2025 – Complete Study Guide

In this clinical scenario, the symptoms presented indicate that the most likely disease state is a pleural effusion. The presence of dyspnea suggests the patient is experiencing difficulty breathing, which can occur with any significant lung pathology. Diminished breath sounds noted on examination indicate a lack of airflow, which can be due to fluid accumulation in the pleural space, characteristic of pleural effusions.

The flat percussion note on the left is a critical sign. In the case of a pleural effusion, fluid will accumulate in the pleural space and lead to a dull or flat sound upon percussion, as opposed to the resonance expected over normal lung tissue. This contrasts with a pneumothorax, which would produce hyperresonance due to air in the pleural space, or a hemothorax, where a dull sound would also occur, but with more association to blood specifically.

Additionally, the observed tracheal shift to the right indicates a significant alteration in mediastinal structures, which can occur in the setting of a large pleural effusion. Fluid accumulation on one side, as would occur with a pleural effusion, can push the trachea towards the opposite side.

Overall, the combination of diminished breath