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A 37 year-old woman presents with 10-days of progressive exertional dyspnea. Her review of systems was pretty unremarkable. She denied any fevers, chills, cough, sputum production or weight loss. The only recent event that she can recall was that she had an upper respiratory tract infection 3 months ago at the same time that multiple family members were sick. Her symptoms resolved without antibiotic therapy. Her only past medical history is allergic rhinitis. She is a life-long non-smoker and had a recent negative mammogram.  A chest x-ray is performed and is shown below:


chest x-ray


Most likely diagnosis?

A) Bronchogenic carcinoma

B) Pulmonary edema

C) Pulmonary fibrosis

D) Pleural effusion

E) Pneumonia

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D) Pleural effusion