A 62-year-old retired fire performer came to the emergency department complaining of persistent cough, difficulty breathing, and unintentional weight loss over the last two months. He also mentioned a history of occasional fever but denies night sweats and has not travelled outside of Canada. He shared his past as a fire performer, often swallowing and blowing fire using petroleum-based fuels. He has a 20-pack-year history of smoking and was diagnosed with COPD 5 years ago. On examination, the patient was observed to be in mild respiratory distress with an oxygen saturation of 92% on room air, and auscultation revealed decreased breath sounds in the right lower lung field. Chest radiograph showed a right lower lobe consolidation, as shown in the image, and a high-resolution CT scan revealed diffuse ground-glass opacities in both lungs with areas of consolidation in the right lower lobe. Lab results revealed an elevated white blood cell count and C-reactive protein level. The bronchoscopy showed nothing unusual; culture for acid-fast bacilli and fungi came back negative, with the cytology only highlighting the presence of foamy macrophages. Which of the following is the most likely diagnosis

Based on the patient's history and physical examination findings?

Real-Life cases to ensure you are ready for your MCCQE1 Exam!

Ace Qbank Clinical Edge


Ace Qbank Clinical Edge

Making the proper diagnosis is one of the most important aspects of any medical student’s or junior doctor’s clinical training and hence we created Clinical Edge Cases.

Ace Qbank Clinical Edge helps our students put their knowledge of symptoms and physical findings to test by applying clinical reasoning and assessment concepts to a series of common clinical vignettes. Problem-based learning is being used to focus on the cause behind the presentation of a simulated clinical case.

Each simulated Clinical Edge case contains a list of common causes of the presented condition, offers abundant references to the presented case, making additional information easy to find

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