Case Study: Pulmonary Continued

Patient: S.J. is a 35 year old female presents to the primary care office with complaints of sharp chest pain localized to the left side, exacerbated by breathing deeply or coughing. Pain started abruptly 2 days ago and has persisted since. Denies shortness of breath, wheezing, or coughing up blood. No recent upper respiratory tract infections or fever. Medical History: Asthma (well-controlled), no history of lung infections Current Medications: Albuterol inhaler as needed for asthma Social History: Non-smoker, no history of substance abuse. Vital Signs: Blood pressure 120/80 mmHg, heart rate 75 bpm, respiratory rate 16 breaths/min, temperature 98.6F. Respiratory Examination: Reduced breath sounds over the left lower chest area. Pleuritic chest pain reproduced upon palpation of the chest wall. Cardiovascular Examination: Normal heart sounds, no murmurs or irregularities detected. Discussion Questions: What are your top differential diagnoses for this patients pleuritic chest pain, and what clinical findings support each? Diagnostic workup (if any) Pharmacologic and Non-pharmacologic management plan Peer Response: What red flag symptoms would prompt urgent reevaluation? Are there any psychosocial stressors that could contribute to chest wall pain that should be explored? If so, what screenings could you use?