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Postoperative atelectasis — USMLE Step 2 CK MCQ

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ModerateSurgeryPostoperative atelectasisUSMLE Step 2 CK

A 61-year-old African American man comes to the hospital because of progressive symptoms. History and focused examination are notable for low-grade fever and bibasilar crackles on the first postoperative day. Temperature is 102.2°F (39.0°C), blood pressure is 108/66 mmHg, pulse is 112/min, respirations are 22/min, and oxygen saturation is 94% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and imaging support an acute surgical process without suggesting a safer outpatient approach. Which of the following is the most likely diagnosis?

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Correct answer: E — Postoperative atelectasis

The vignette describes Postoperative atelectasis, supported by low-grade fever and bibasilar crackles on the first postoperative day. Postoperative atelectasis is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: https://www.ncbi.nlm.nih.gov/books/#stage-9-order-30