326) A 55 year old african-american man presents to your office with complaints of shortness of breath that has slowly progressed over the past several months. He also reports chest pain which in non-pleuritic in nature. He has lost about 10lbs weight in the past three months. He has changed several jobs but he currently works as a sales representative for a drug company. On examination, his temperature is 100F, Pulse 98/min, RR 20/min and Blood Pressure 100/60 mm HG. He is in mild distress due to shortness of breath. On chest examination, there is dullness to percussion over the right side of the chest. No masses are palpable. Laboratory investigations reveal WBC 8k/μl with normal differential, Hgb 10.5gm%, Platelets 550k/μl, Calcium 11.2gm% ( (Normal 8.9 to 10.5 mg%)
A chest-x-ray is shown below: 
Which of the following element in the history would be most helpful in making a presumptive diagnosis of his presentation?
A) Smoking
B) Family history of Cancer
C) Bone pain
D) Flank pain and Hematuria
E) Previous Occupation
aa
a
b
look at the x-ray. What do you see? Is there any parenchymal involvement or just pleural?
e ,,, pleural effusion with losing of weight.. ask for Asbestos Exposure and Silica.
A….