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History :
26 yo male with c/o cough. Pt complains symptom began one week ago and is described as sharp.
The pain is located in his right chest and increases with deep breathing and while coughing. Pt denies
other associated symptoms. Patient describes the severity of his pain as an 8/10.
PMH: history of Gonorrhea, treated with antibiotics
allergies- none
Medications- Tylenol PRN
Hospitalizations- none
FMH- not significant
occupancy- Pizza delivery
Diet- regular
exercise -yes

Physical Examination :

Neuro: AAOx3
HEENT: clear nasal turbinates, clear throat, eyes
Lung: increased tactile fremitus, decreased breath sounds of right lung
CV: RRR, S1 S2 regular sinus rhythm

Diagnosis 1 :
Pneumonia

History Findings Physical Exam Findings

1) increased Tactile fremitus
2) decreased breath sounds

Diagnosis 2 :
emphysema

History Findings Physical Exam Findings

1) coughing while taking deep breath 1) increased tactile fremitus
2) 11 pack year history

Diagnosis 3 :
Bronchial Asthma
 History Findings Physical Exam Findings
1) coughing while taking deep breath 1) decreased breath sounds

Diagnostic Study/Studies - Labs

1) CBC
2) CMP
3) Chest Xray