Rosh Emergency Medicine Practice Test

What examination finding is often present in a patient with pneumonia upon auscultation of the lungs?

1. Wheezing

2. Rales

3. Dullness to percussion

4. Stridor

The correct answer is: Rales

In the context of pneumonia, the presence of rales, also known as crackles, is a commonly observed auscultation finding. Rales are indicative of fluid in the alveoli or small airways, which is characteristic of pneumonia, as inflammation and infection lead to the accumulation of fluid, pus, or other exudates in the pulmonary tissue. On auscultation, these bubbly or crackling sounds occur during inspiration and suggest the involvement of lung tissue, aligning with the pathophysiological changes that occur during a pneumonia infection. While other findings, such as wheezing, may occur in conditions like asthma or bronchospasm and may not be prevalent in pneumonia, rales specifically signify the presence of abnormal lung sounds due to fluid, making them a classic finding in cases of pneumonia. Similarly, dullness to percussion may indicate fluid or mass in the pleural space but is less definitive than rales in relation to pneumonia itself. Stridor typically denotes upper airway obstruction and is not associated with pneumonia. Thus, the presence of rales upon auscultation is the key finding that indicates pneumonia.