Intensive Care Medicine (ICM) Practice Exam

What can indicate the presence of pleural rub?

1. Dyspnea upon exertion

2. High-pitched wheezing sounds

3. Chest pain upon breathing

4. Shortness of breath

The correct answer is: Chest pain upon breathing

The presence of pleural rub is often indicated by chest pain upon breathing. A pleural rub occurs when the visceral and parietal pleurae become inflamed and rub against each other during respiration. This is commonly associated with conditions such as pleuritis or pneumonia. The resulting friction can lead to localized pain that is typically sharp and worsens with deep breathing or coughing, making chest pain upon breathing a relevant symptom. Other symptoms such as dyspnea upon exertion, high-pitched wheezing sounds, and shortness of breath can be indicative of various respiratory or cardiac conditions, but they are not specific to a pleural rub. While pleural effusion or lung pathology can also lead to dyspnea and shortness of breath, these symptoms do not directly reflect the mechanical interaction between the pleurae that characterizes a pleural rub. Therefore, chest pain upon breathing is the most directly associated clinical symptom with this condition.